Cosmetic News October 2013

FACING PREJUDICE Facial disfigurement

NO-TOX Botulinum toxin alternatives

CLIENT RETENTION

T H E A E S T H E T I C A W A R D S 2 0 1 3 , 7 D E C E M B E R 2 0 1 3 . B O O K Y O U R T I C K E T T O D A Y.

COSMETIC NEWS THE UK’S LEADING TRADE TITLE FOR MEDICAL AESTHETIC PROFESSIONALS

Looking after existing clients

ALSO IN THE OCTOBER ISSUE OF COSMETIC NEWS...

PENOPLASTY

BODY SHAPING AND NUTRITION

CUSTOMER SERVICE

Patients prefer Belotero...

Clinical studies show a preference for Belotero over Restylane® and Juvéderm® Ultra 31,2

Superior evenness1 ®

Comparable cosmetic correction1 ®

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Comparable duration2

1. Prager W et al. A Prospective, Split-Face, Randomized, Comparative Study of safety and 12-Month Longevity of Three Formulations of Hyaluronic Acid Dermal Filler for Treatment of Nasolabial Folds. Dermatol Surg 2012, 38: 1143 – 1150.

2. Narins R. S. et al. Improvement in Nasolabial Folds with a Hyaluronic Acid Filler using a Cohesive Polydensified Matrix Technology: Results from an 18-month Open-label Extension Trial. Dermatol Surg. 2010 Nov;36 Suppl 3:1800-8.

Restylane is a registered trademark of Galderma S.A. Juvéderm is a registered trademark of Allergan Inc.

Call Merz Aesthetics Customer Services now to find out more or place orders: Tel: +44(0) 333 200 4140 Fax: +44(0) 208 236 3526 Email: customerservices@merz.com Date of preparation September 2013

BEL073/0913/LD

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Editor’s Letter Welcome to the October issue of Cosmetic News.

When we think of facial aesthetics we often just think about anti-ageing and elective treatments but what about those clients who seek out cosmetic enhancement because of facial disfigurement? In an in depth article, Dr Patrick Treacy explores this side of the aesthetic market and the impact it has on patients (p16-18).

Of course the main focus of aesthetic medicine has always been anti-ageing and lines and wrinkles are often top of the list of concerns. Botulinum toxin and dermal fillers have become the staple treatments of most aesthetic practices but in recent years, finding non-invasive alternatives to botulinum toxin injections has become a bit of a holy grail quest. As such, this month, we have decided to ask some leading aesthetic practitioners to give their views on two non-toxin alternatives to the wrinkle-busting jab (see pages 20 and 22). We also examine the results of a clinical study comparing Uma Jeunesse and Juvederm (p24-26) and speak to Dr Roberto Veil about the growing trend for penis enlargement (p30).

Vicky Eldridge, Editor

As well as this Antonia Mariconda explains why good customer service and front of house staff are so important to your business (p46-47) and Dr Natalie Blakely explains the increasing use of cloud based technology in aesthetics (p43-44).

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Contents INDUSTRY INSIDER 4 EDITOR’S CHOICE

Vicky Eldridge on the CACI Skinbreeze treatment 6 INDUSTRY NEWS

We round up the latest industry news 14 AESTHETIC AWARDS 2013

Why you should attend the most prestigious event of the aesthetics calendar CLINICAL PRACTICE 16 FACIAL DISFIGUREMENT

Dr Patrick Treacy on the aesthetics of beauty and the social stigmatisation of facial disfigurement

BOTULINUM TOXIN ALTERNATIVES 20 A TOPICAL ISSUE

Dr Sotirios Foutsizoglou on whether Argireline® really offers a topical alternative to botulinum toxin 22 ‘FRO-TOX’

Dr Vincent Wong on iovera° 24 CLINICAL STUDY

We examine the results of a study comparing Uma Jeunesse® and JUVÉDERM® 28 NUTRITION AND BODY SHAPING

Nutritionist Kim Pearson on the importance of addressing diet with liposuction and body shaping patients 30 Q&A

We talk to Dr Robert Viel about the growing trend for penoplasty PRODUCT REVIEWS 32 PRODUCT FOCUS

We find out about the new Stem Cell systems from Wellness Trading 34 TRIED AND TESTED

We speak to skin specialist Debbie Thomas about Dermaceutic’s signature pigmentation peel 36 PRODUCT NEWS

We round up the latest product news IN BUSINESS

Editor’s choice

Skinbreeze

Not all patients who walk through your clinic’s door want to have injectables and, as such, a lot of treatments emerge onto the market claiming to be non-invasive alternatives to Botox® and fillers.

One such treatment is Skinbreeze from CACI. Skinbreeze has been launched as a solution for clients looking for an effective anti-ageing treatment without side effects. The treatment is a hybrid of a cutting-edge new skinresurfacing system, LED light-therapy and a high pressure O2 infusion of a unique rejuvenating serum – containing neuropeptides, which are claimed to mimic the effects of Botox® in a topical application. I went to find out more about the treatment and try it out for myself with leading skin specialist Debbie Thomas.

The treatment is performed in two steps. The first part of the treatment is a gentle orbital dermabrasion. It uses replaceable tips coated with silicon carbide in three levels of coarseness to massage and gently exfoliate the surface of the skin. Unlike most other dermabrasion systems Skinbreeze doesn’t use harsh crystals, which can painfully “sandblast” the skin’s surface. The dermabrasion tips can be set to rotate on an elliptical axis at 20 different speeds to remove imperfections and impurities. Simultaneous mechanical vibrations massage the skin, making the procedure a more comfortable experience. In addition blue and red light therapy is used simultaneously to stimulate and plump the new tissue underneath.

The second step uses powerful high pressure O2 infusion delivers the Skinbreeze serum to the skin to visibly plump out lines and increase firmness. The O2 infusion propels the active Skinbreeze serums deep into the lower layers of the dermis substantially increasing the volume of the skin, plumping and smoothing lines and wrinkles providing a painless and needle-free alternative to dermal fillers. An air-powered spray gun is then used to deliver an even application of active serum ingredients in a fine mist across the treatment area to hydrate and gently refresh and calm sensitive and sun-damaged skin.

39 CUSTOMER SERVICE

Antonia Mariconda on why good customer service and front of house staff are so essential to the success of your practice 43 BUSINESS FOCUS

Dr Natalie Blakely on cloud based patient management system 46 IN PRACTICE

Zoe Davitt from Blue Horizons on the importance of client retention 49 BEST PRACTICE

Richard Crawford-Small on Consumer Services vs Customer Experiences

The Skinbreeze treatment is ideal for clients who want to rejuvenate their skin but who are looking for a less aggressive option with no side effects. A course of 10 treatments is recommended for optimum results and the serums can also be used at home in between treatments. The other thing that will appeal to clients is that it is more affordable than some other treatments for clients who are on a budget and has lower outlay costs for the clinics so everyone’s a winner!

CONTACT THE COSMETIC NEWS TEAM ON 01268 754 897 PUBLISHED BY

52 TOP TIPS FOR SUCCESS

Richard Crawford-Small gives us his top 5 tips for business success 54 AESTHETICS CONFERENCE AND EXHIBITION 2014

Everything you need to know about why you should attend 56 DATES FOR THE DIARY

The latest dates for your diary

Vicky Eldridge Editor | M: 07880 812 582 | vicky@cosmeticnewsuk.com Hollie Dunwell Sales Manager | M: 07557 359 257 | hollie@cosmeticnewsuk.com Peter Johnson Art Director | 0207 148 0408 | peter@cosmeticnewsuk.com Chiara Mariani Designer | 0207 148 0408 | chiara@cosmeticnewsuk.com Craig Christie Administration and Production | 01268 754 897 | support@cosmeticnewsuk.com DISCLAIMER

The editor and the publishers do not necessarily agree with the views expressed by contributors and advertisers nor do they accept responsibility for any errors in the transmission of the subject matter in this publication. In all matters the editor’s decision is final.

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INDUSTRY NEWS

BOOK YOUR TICKET FOR THE AESTHETIC AWARDS 2013 - DECEMBER 7

National Institute of Aesthetic Research launches

Give your feedback on Cosmetic News and win an iPad Mini

The Annual Scientific Meeting of the British Association of Aesthetic Plastic Surgeons marked the launch of the governmentendorsed National Institute of Aesthetic Research. The joint initiative between BAAPS and the Healing Foundation will be housed at the Royal College of Surgeons to ‘sift’ through fact and fiction to establish real evidence in the science of aesthetics.

There are just a few weeks left to take part in Cosmetic News’ reader survey and be in with a chance to win an iPad Mini.

New publishers Synaptiq created the short questionnaire to ensure the publication is meeting the needs of its readers and gauge industry views and opinions on the content of the journal. You can fill the survey out by visiting http://www.smartsurvey. co.uk/s/CNreadersurvey. As a thank you for completing the survey, you will be entered into a prize draw where you could win a new iPad Mini.

Medical director of the NHS Sir Bruce Keogh said, “I welcome the announcement from the Healing Foundation and BAAPS on the launch of the National Institute of Aesthetic Research (NIAR). This joint initiative is the first recommendation of my review to be implemented and I know it will provide a major contribution to patient safety.”

Among many other projects, NIAR will be launching a new initiative into breast implant safety.

‘Luxury’ inducements continue to glamorise procedures says BAAPS Time-linked incentives, group deals and other inducements continue to flourish unabated in the industry, despite recommendations in the Keogh review, new studies unveiled at the annual scientific meeting of the British Association of Aesthetic Plastic Surgeons, have shown.

Sinclair hosts company sales meeting in Barcelona

One study revealed that more than half (52%) of the highest Google-ranking aesthetic plastic surgery providers still offer promotional deals; often tied with luxury-themed ‘perks’ such as chauffeurs, free photo shoots and holiday destinations; out of which nearly two in five (37%) were time-linked.

Another study looking into providers of non-surgical treatments showed three out of five (58%) were offering incentives. Worryingly, a third (32%) of these providers did not even specify who actually administered the treatments and over a quarter (26%) made no mention whatsoever of qualifications. Sites where these facial procedures could take place included shopping centres, gyms and even ‘at-home parties’. Only a fifth (22%) of the procedures were offered in facilities registered with the Care Quality Commission (CQC).

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References: 1. Raspaldo H. J Cosmetic and Laser Therapy, 2008;10:134–142. 2. Fischer TC. Poster presented at EMAA, 1–3 October 2009, Paris. 3. Allergan Data on File (DoF), 2011.

4. Allergan Data on File (DoF) Marketing overview, 2011. Instructions and directions for use of JUvéDeRm® vOLUmA® with Lidocaine are available on request. Lidocaine does not affect the intrinsic performances of JuvéDERM® vOLuMA® and its safety profile, therefore, JuvéDERM® vOLuMA® data is representative of JuvéDERM® vOLuMA® with Lidocaine3

Date of Preparation: January 2013 UK/0008/2013a

Sinclair’s UK sales team travelled to Barcelona for the company’s sales meeting. Pictured are Andrew Morris (chief operations director), Katrina Ellison (brand manager aesthetics) , Rebecca Borthwick (training manager), Greg Parker (national sales manager), Farah Zafar (contracts manager) and Emma Rothery (senior brand manager) with Dr David Evans and Mrs Jean Evans.

BAAPS president Mr Rajiv Grover commented, “This new yet sadly unsurprising evidence shows that despite the recommendations of Sir Bruce Keogh’s review, the most popular providers continue to advertise financial inducements and ‘luxury’ incentives, clearly reinforcing the preposterous notion that surgery is part of a celebrity-style status symbol involving photo shoots and ‘chauffeur services’. There is nothing glamorous about surgery and these serious (and irreversible) procedures should not be sold alongside aspirational perks as if they were part of a jet-setting lifestyle.”

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BOOK YOUR TICKET FOR THE AESTHETIC AWARDS 2013 - DECEMBER 7

New light-activated suncream will cut skin cancer

Sector is ‘unconvinced’ by government review

Researchers from the University of Bath’s Department of Pharmacy and Pharmacology have created an innovative ingredient which when applied in a suncream can act as a UVA filter and provide fuller protection against skin damage.

The new compounds are light activated when exposed to relevant doses of UVA, and unique in how they release anti-oxidants to neutralise free radicals whilst at the same time capturing excess iron in the skin. Dr Charareh Pourzand, Researcher in Pharmacy and Pharmacology said, “Antioxidants have already been used as a means to counteract the skin damage caused by UVA. However these agents are not effective, since the simultaneous release of iron in the cells continues to generate more harmful free radicals. The use of ‘naked’ iron chelators for skin protection is also not adequate, since such agents would starve the cells from the iron that is necessary. The molecules we have developed respond to sunlight and provide a safe solution to this problem. The potential medical impact of this project is significant as the caged-iron chelators could provide a highly effective means of protection against UVA- and UVB-induced skin damage and associated skin cancer.”

Less than a third of doctors, nurses and surgeons in the cosmetic surgery arena believe that the recommendations from Sir Bruce Keogh’s recent review into the sector go far enough, and three quarters (75%) think there could still be a repeat of a health scandal such as the recent breast implant crisis, according to a new survey by the Clinical Cosmetic and Reconstructive Expo.

The survey showed that clinicians lay the blame squarely on the lack of government regulation, unethical marketing by practitioners themselves and irresponsible reporting by the media for the situation. They feel advertising needs to be strictly controlled, and the practice of using airbrushed models instead of real patients banned outright.

According to consultant plastic surgeon and Chairman of the Expo’s Medical Advisory Board Norman Waterhouse, “Bruce Keogh’s recently published review is not the first government report on safety and regulation in aesthetic surgery.

In the past recommendations of reviews have been largely ignored and if one were cynical many clinicians feel that this recent review has been fast tracked as a result of the implant scandal - and are not holding their breath in terms of expecting concrete measures for implementation of the recommendations.”

No more antibiotics for acne A controversial proposal published on Medscape.com, a web resource for physicians and other health professionals, has called for the discontinuation of antibiotics to treat acne. The proposal by Muneeza Muhammad, BA and Ted Rosen, MD, suggests that dermatologists should severely curtail or outright discontinue the routine and regular use of antibiotics for acne.

Given the numerous possible side effects of antibiotics and the prevalence and worsening of P. acnes (the bacteria that causes acne) resistance worldwide, the proposal prompts doctors to think more carefully about their prescribing habits and highlights a number of alternative therapies that are easy to use and effective in treating acne. This includes the use of photodynamic light therapy to treat acne. Dr Robin Stones, dermatologist and Medical Director at Courthouse Clinics said, “Bacterial resistance to antibiotics is a global problem, which is a cause for serious concern. The emergence of the so-called “superbugs” which are resistant to most antibiotics and therefore difficult to treat is a major threat to health. In many areas of the world more than 50% of acne bacteria are resistant to the antibiotics used to treat the condition and the rates are continuing to rise.”

Top dermatologist publishes book Renowned dermatologist, Dr Stefanie Williams, has written a book revealing previously unknown secrets to slow down the ageing process at a cellular level. Future Proof Your Skin outlines Dr Williams’ Future Food PlanTM, which is based on years of scientific research. She explains, “It is estimated that 30 to 40% of all cancers and an even higher percentage of diabetes and cardiovascular disease could be prevented by the lifestyle and dietary measures alone. The underlying goal of the Future Food PlanTM is to take optimal health into high age. For me this equals true anti-ageing. Having beautiful looking skin is simply a great side effect of this.”

AL Aesthetics celebrates 1st anniversary and re-vamp ENT Surgeon and cosmetic specialist Ash Labib celebrated the launch of his new clinic AL Aesthetics in Wolverhampton, West Midlands recently.

Guests were treated to champagne, canapés and entertainment to celebrate the clinic’s one year anniversary and interior revamp and re-launch. Guest of Honour Antonia Mariconda, The Cosmedic Coach, gave a speech to guests on ‘the importance of finding a good doctor’ and officially toasted the clinics celebrations. Mr Labib worked at Russell’s Hall Hospital and New Cross Hospital in the Midlands for over 21 years and sub-specialised in rhinology and rhinoplasty. Over the last four years he has gained vast experience as a cosmetic specialist. He has also worked at a number of skin clinics using his special interest in facial rejuvenation and anti-ageing treatments.

Practitioners & their patients feel the difference...

“The favourable safety profile has lead to high patient satisfaction and subsequent recommendations from one patient to another, increasing our practice1”

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1. Kuhne, U et al. Five-year retrospective review of safety, injected volumes, and longevity of the hyaluronic acid Belotero Basic for facial treatments in 317 patients.

J Drugs Dermatol. 2012 Sep; 11(9):1032-5 2. Data on File: BEL-DOF2_001 Belotero Juvederm Study MRZ 90028_4007

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Media coverage of health watchdog announcement over risk of infection from dirty needles causes industry concern Media coverage of a press release issued by health watchdog The National Institute for Health and Care Excellence has caused concern in the industry by suggesting that people having cosmetic injectable treatments could be at risk of infection from dirty needles.

The National Institute for Health and Care Excellence is updating its advice for England and Wales. The guidelines, which are out for public consultation, aim to encourage people to use sterile needle and syringe programmes to stem the spread of infections. The guidelines were primarily designed to advise on needle exchange practices for people who are misusing heroin and other opiates or anabolic steroids, however, the media coverage generated by the release focussed largely on a reference that growing numbers of people were injecting tanning agents, dermal fillers and Botox® at home and in salons and were lax about hygiene. In reality this is negligible but the headlines have once again generated negative publicity for cosmetic injectables.

Mr Rajiv Grover, consultant plastic surgeon and president of the British

Association of Aesthetic Plastic Surgeons (BAAPS), said, “Due to the lack of regulation in the cosmetic sector it is impossible to know how many patients could be at risk of blood borne diseases from needle sharing with either Botox® or fillers.These should be considered medical procedures and BAAPS has campaigned for over a decade to have this field of non-surgical cosmetic treatments tightly regulated. The dangers of sharing needles in cosmetic injectables are so great that any practitioner who does this should be considered guilty of a criminal offence and nothing less.”

A spokesman for Allergan said, “Allergan question the evidence that firstly, significant numbers of people in the UK are purchasing BOTOX® (botulinum toxin type A) or dermal fillers online for self-administration, and secondly, that there has been an increase in this practice since 2009. In response to the alarmist media coverage, we have been working to reassure patients that qualified medical healthcare practitioners working in appropriate clinical settings adhere to best practices in needle usage and therefore there is negligible risk of infection.”

Rederm Partners with Meder Beauty Rederm has launched basic and advanced aesthetic skills courses in association with Meder Beauty Science.

The courses are practically orientated and emphasise hands on practical skills with a post course mentorship and support programs.They are open to all aesthetic practitioners and cover both theoretical and practical skills. A mentorship program and free medical aesthetic seminars are available to build confidence and help in those difficult situations when taking the first step into the medical aesthetic business.

Sigmacon announcements Sigmacon (UK) Limited has announced two new launches.

The company is now the UK distributor of PCA SKIN, a global organisation serving over 5,000 medical practices in the United States. The company has also launched its new business - Unique Skin - in combination with a dedicated online website store Uniqueskin.co.uk. Sigmacon’s aesthetic General Manager and Unique Skin business director, Julian McGlynn said, “We wanted a business that could offer our existing customers professional skincare products from PCA SKIN, combined with the very popular Professional Dermatological Skin Peels and daily care products from Dermaceutic Laboratoire.”

Chromogenex launch i-LipoXcell to the US British laser manufacturer Chromogenex Technologies has officially launched the i-LipoXcellin he US. The introductory launch, which took place in Fort Lauderdale, Florida saw CEO Peter McGuinness and technical product director Kevin Williams discuss the science behind the breakthrough, emphasising the benefits of cell biostimulation over cell destruction. The new technology incorporates both visible red and Infra red laser for biostimulation of metabolic pathways resulting in the release of fatty acids and glycerol, and hence shrinking the fat cells of the targeted area.

Kevin Williams said “We are very excited about the official US market launch due to take place in the Waldorf Astoria, New York in October 2013 and can’t wait to see what the future holds.”

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Following the of of non-surgical Aesthetic skincare market. Following success the success the award winning 3D-lipo which combines technologies for the the award winning 3D-lipo which combines technologies for the effective treatment of of fat,fat, cellulite andand skin-tightening we are effective treatment cellulite skin-tightening we set are set to launch a phenomenal new multi-functional device for the face. to launch a phenomenal new multi-functional device for the face.

Here are just some of the reasons why 3D-skintech will become the Here are just some of the reasons why 3D-skintech will become the brand of choice in 2013 brand of choice in 2013 • Complete treatment portfolio for anti-ageing, •pigmentation Complete treatment and acne portfolio for anti-ageing, pigmentation and acne • 4 technologies ensure a prescriptive & total approach •to4your technologies ensure a prescriptive & total approach clients needs to your clients needs • Used in conjunction with medical peel and •cosmeceutical Used in conjunction skin carewith line medical peel and cosmeceutical skin care line • Unsurpassed results ensures maximum •client Unsurpassed results ensures maximum loyalty clientprofitable loyalty with a multitude of • Highly •services Highly to profitable offer with a multitude of • Provides servicesyou to with offera competitive in youryou area •edge Provides with a competitive • Affordable as package edge in your area price is under £10,000 a product • Affordable aswith package price is starter pack worth £1,000 under £10,000 with a product • Affordable finance packages starter pack worth £1,000 available • Affordable finance packages

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LEDLED ensures both rapid treatment time and excellent Full canopy Fullachieved. canopy LED ensures both rapid treatment and excellent results are Available wavelengths Red (640nm time - 700nm), Blue (425nm - 470nm), YellowAvailable (590nm) and Green (520 - 564nm) results are achieved. wavelengths Red (640nm - 700nm), ensuresBlue effective treatment for anti-ageing, pigmentation, acne and- 564nm) (425nm - 470nm), Yellow (590nm) and Green (520 detoxification. ensures effective treatment for anti-ageing, pigmentation, acne and detoxification.

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A compact range of medical grade peels and cosmeceutical 3D-skintech peels and clinical skincare skincare productsA complete Skintech’s unique offering you compact the range of medical grade peelsand andenables cosmeceutical skincar to both use as a “stand-alone” or combine equipment products complete theservice Skintech’s unique with offering and enables you protocols. to both use as a “stand-alone” service or combine with equipment protocols.

‘To compliment our core injectable business the 3D-skintech has added an array of new result driven facial services to our clinic’s menu as well as the combination services for ‘Tocurative compliment ourWe core injectablethat business the 3D-skintech has added an array of n our more patients. recognized this device offered the stand alone quality driven infacial services to our clinic’s menu that as well as the combination of eachresult technology a unique machine that will ensure we both deliver the resultsservices but equally can make money from the due its that affordability.

As offered a clinician many our more curative patients.

We start recognized this device thetoo stand alone qu times inofthe past we have invested huge sums ofthat money in a single has the res each technology in a unique machine will ensure that concept we boththat deliver proven but difficult to profit my opinion system represents the in our too m equally can from. makeInmoney fromthis thetype startof due its affordability.

Asfuture a clinician industry.’

Dr Martyn GPhave and Clinical director Skin Clinic times in the King past –we invested huge Cosmedic sums of money in a single concept that proven difficult to profit from. In my opinion this type of system represents the future in industry.’ Dr Martyn King – GP and Clinical director Cosmedic Skin Clinic

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Bocouture® 50 Abbreviated Prescribing Information Please refer to the Summary of Product Characteristics (SmPC). Presentation 50 LD50 units of Botulinum toxin type A (150 kD), free from complexing proteins as a powder for solution for injection. Indications Temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at frown (glabellar frown lines) in adults under 65 years of age when the severity of these lines has an important psychological impact for the patient. Dosage and administration Unit doses recommended for Bocouture are not interchangeable with those for other preparations of Botulinum toxin. Reconstitute with 0.9% sodium chloride. Intramuscular injection (50 units/1.25 ml). Standard dosing is 20 units; 0.1 ml (4 units): 2 injections in each corrugator muscle and 1x procerus muscle. May be increased to up to 30 units.

Not recommended for use in patients over 65 years or under 18 years.

Injections near the levator palpebrae superioris and into the cranial portion of the orbicularis oculi should be avoided. Contraindications Hypersensitivity to Botulinum neurotoxin type A or to any of the excipients. Generalised disorders of muscle activity (e.g. myasthenia gravis, Lambert-Eaton syndrome). Presence of infection or inflammation at the proposed injection site. Special warnings and precautions Should not be injected into a blood vessel. Not recommended for patients with a history of dysphagia and aspiration. Adrenaline and other medical aids for treating anaphylaxis should be available. Caution in patients receiving anticoagulant therapy or taking other substances in anticoagulant doses. Caution in patients suffering from amyotrophic lateral sclerosis or other diseases which result in peripheral neuromuscular dysfunction. Too frequent or too high dosing of Botulinum toxin type A may increase the risk of antibodies forming. Should not be used during pregnancy unless clearly necessary. Interactions Concomitant use with aminoglycosides or spectinomycin requires special care. Peripheral muscle relaxants should be used with caution. 4-aminoquinolines may reduce the effect. Undesirable effects Usually observed within the first week after treatment. Localised muscle weakness, blepharoptosis, localised pain, tenderness, itching, swelling and/or haematoma can occur in conjunction with the injection. Temporary vasovagal reactions associated with pre-injection anxiety, such as syncope, circulatory problems, nausea or tinnitus, may occur. Frequency defined as follows: very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1000, < 1/100); rare (≥ 1/10,000, < 1/1000); very rare (< 1/10,000). Infections and infestations; Uncommon: bronchitis, nasopharyngitis, influenza infection.

Psychiatric disorders; Uncommon: depression, insomnia Nervous system disorders; Common: headache. Uncommon: facial paresis (brow ptosis), vasovagal syncope, paraesthesia, dizziness. Eye disorders; Uncommon: eyelid oedema, eyelid ptosis, blurred vision, eye disorder, blepharitis, eye pain. Ear and Labyrinth disorders; Uncommon: tinnitus. Gastrointestinal disorders; Uncommon: nausea, dry mouth. Skin and subcutaneous tissue disorders; Uncommon: pruritus, skin nodule, photosensitivity, dry skin. Musculoskeletal and connective tissue disorders; Common: muscle disorders (elevation of eyebrow), sensation of heaviness; Uncommon: muscle twitching, muscle cramps. General disorders and administration site conditions Uncommon: injection site reactions (bruising, pruritis), tenderness, Influenza like illness, fatigue (tiredness). General; In rare cases, localised allergic reactions; such as swelling, oedema, erythema, pruritus or rash, have been reported after treating vertical lines between the eyebrows (glabellar frown lines) and other indications. Overdose May result in pronounced neuromuscular paralysis distant from the injection site. Symptoms are not immediately apparent post-injection. Bocouture® may only be used by physicians with suitable qualifications and proven experience in the application of Botulinum toxin. Legal Category: POM. List Price 50 U/vial £72.00 Product Licence Number: PL 29978/0002 Marketing Authorisation Holder: Merz Pharmaceuticals GmbH, Eckenheimer Landstraße 100, 60318 Frankfurt/Main, Germany. Date of revision of text: FEB 2012. Full prescribing information and further information is available from Merz Pharma UK Ltd., 260 Centennial Park, Elstree Hill South, Elstree, Hertfordshire WD6 3SR. Tel: +44 (0) 333 200 4143 Adverse events should be reported. Reporting forms and information can be found at yellowcard.mhra.gov.uk Adverse events should also be reported to Merz Pharma UK Ltd at the address above or by email to medical.information@merz.com or on +44 (0) 333 200 4143.

1. Frevert J. Content in BoNT in Vistabel, Azzalure and Bocouture. Drugs in R&D 2010-10(2), 1-7 2. Prager, W et al. Onset, longevity, and patient satisfaction with incobotulinumtoxinA for the treatment of glabellar frown lines: a single-arm prospective clinical study. Clin. Interventions in Aging 2013; 8: 449-456.

3. Sattler, G et al. Noninferiority of IncobotulinumtoxinA, free from complexing proteins, compared with another botulinum toxin type A in the treatment of glabelllar frown lines. Dermatol Surg 2010; 36: 2146-2154.

4. Prager W, et al. Botulinum toxin type A treatment to the upper face: retrospective analysis of daily practice. Clin. Cosmetic Invest Dermatol 2012; 4: 53-58.

5. Data on File: BOC-DOF-11-001_01 Bocouture® is a registered trademark of Merz Pharma GmbH & Co, KGaA. Date of preparation: August 2013 1102/BOC/AUG/2013/LD

THE AESTHETIC AWARDS

A NIGHT TO REMEMBER

We tell you why you cant afford to miss the most prestigious event of the aesthetics calendar - The Aesthetic Awards 2013

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ecognising and rewarding excellence is key to the success of any industry, especially in an industry like medical aesthetics where best practice and standards are so integral to both public perception and market growth. The Aesthetic Awards are an unprecedented opportunity to do just that by celebrating the successes and achievements of aesthetics businesses, products and services.

Now in its third year, the Aesthetic Awards is the premier awards evening for the aesthetics industry and has quickly become the most eagerly anticipated event in the social calendar. This year’s event will be marked by a classy black tie Winter Wonderland ceremony at the Grange Hotel, Tower Bridge in London on December 7. Sponsored by Syneron Candela and Cambridge Medical Aesthetics/Uma Jeunesse, the Aesthetic Awards is a chance to celebrate the achievements and innovations of our exciting and dynamic industry at the same time as enjoying a sophisticated evening surrounded by the cream of the aesthetic industry crop. In a market that

has been under scrutiny is the wake of the Keogh report, it is more important than ever that we come together as an industry to acknowledge not just good but excellent practice and those whose credibility and commitment to quality and standards makes them stand out from the crowd. The evening will begin with a champagne reception, which is the perfect opportunity to soak up the buzz of excitement in the air as the anticipation of who will win the coveted trophies builds. The pre-awards drinks reception is a wonderful opportunity to network with your peers and fellow nominees.

A four-course dinner will then ensue with entertainment to warm up proceedings before the awards presentation. The Aesthetics Awards is always a sell out event so, to make sure you don’t miss out, on what promises to be a night to remember.

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FACIAL DISFIGUREMENT

Facing prejudice Dr Patrick Treacy on the aesthetics of beauty and the social stigmatisation of facial disfigurement

A

lthough having a facial disfigurement secondary to trauma, a birthmark, a birth defect or some abnormality does not affect a patient’s health; society deems it often leads to stigmatisation and limitations of opportunities afforded to others.

Dr Patrick Treacy Dr Patrick Treacy is Medical Director of Ailesbury Clinics Ltd and Ailesbury Hair Clinics Ltd. He is Chairman of the Irish Association of Cosmetic Doctors and is Irish Regional Representative of the British Association of Cosmetic Doctors.

Dr Treacy is a renowned international guest speaker and features regularly on Irish breakfast television (TV3), RTE and as an expert panelist with the BBC World Service. He had a series on Discovery Health and the Discovery Channel (New York) filmed a programme about his

Facial disfigurement is the state of having one’s facial appearance harmed medically, either from a disease, birth defect, or trauma. Although this perceived defect does not usually affect a patient’s health; the condition leads to social stigmatisation, isolation and incurs limitations of privileges and opportunities otherwise afforded to those without the problem. It is estimated that presently there are about 40,000 adults and children in the UK (1 in 150 people) with significant facial disfigurements and 1 in 500 children is seriously enough affected by facial disfigurement to result in severe psychosocial problems, poor self-esteem and depression. Studies have shown that the general population respond to people with a facial disfigurement with prejudice; intolerance, less trust and respect and often try to avoid making contact or having to look at them. Although modern reconstructive surgery and medical treatments help in making some of the unusual features less noticeable but usually it doesn’t remove them completely and the patients have to employ coping strategies that include avoidance of social contact, alcohol misuse, and aggression. For those affected, it can turn a simple social event into a major ordeal.

The causes of facial disfigurements are highly variable. At one end of the scale are patients who are born with significant craniofacial abnormalities such as Apert syndrome, while at the other, we have less aesthetically challenging problems secondary to skin conditions such as cystic acne, birthmarks or possibly vitiligo.

In between, we have a myriad of cases secondary to diseases such as elephantiasis or leprosy or because of congenital disfigurements caused by conditions like neurofibromatosis. A few years ago, facial lipodystrophy syndrome (HLS) was a major problem for many HIV patients undergoing long-term use of highly active antiretroviral therapy (HAART).

The psychological facial wasting effects of the condition were extremely distressing and these patients had high levels of depression, suicide as well as social withdrawal and isolation.

work. He is an active member of many international medical societies and is a Fellow of The Royal Society of Medicine.

In fact, a UK study showed that 47% of patients with HLS had HRSD scores for severe depression. It was for this reason and the lack of proper aesthetic therapy to manage this complex condition that I pioneered a facial endoprosthesis technique to replace the malar fat pad in the Ailesbury Clinic some years. It restored dignity to these otherwise socially isolated patients. Thankfully, the new anti AIDS drugs thankfully do not give rise to these types of problems.

Weaved into this myriad of pathologies are those who have already suffered great emotional trauma because of benign or malignant facial cancers, scarring secondary to road traffic accidents or burns etc. While skin conditions like acne scarring or vitiligo make not immediately appear to be of major psychological concern, these patients often disguise their facial disfigurements through camouflage techniques

16 www.cosmeticnewsuk.com

and live a life behind a mask of coloured creams. I personally witnessed this phenomenon treating one of the most famous faces in the world for vitiligo a few years ago. Whatever the cause, society presently dictates that people with a facial disfigurement are perceived seen to be less physically attractive, less socially desirable and less likely to find an acceptable spouse. In this article, I will try and analyse what actually drives such a bias in every cultural society on earth, especially as it is guided towards people who are already often have been the victim or gross trauma or unfairness.

Before we start this exploratory journey, let us define two underlying words; prejudice and belief. The word prejudice comes from the word prejudgment, making a decision before becoming aware of the relevant facts of a case. In recent times, this word has gained prominence when used to refer to legal judgments toward people or a person because of a bias against their gender, religion, race/ethnicity, sexuality or possibly social class. Prejudice is a baseless and usually negative attitude toward members of a particular group. Common features of prejudice include negative feelings, stereotyped beliefs, and a tendency to discriminate against members of the group. While specific definitions of prejudice given by social scientists often differ, most agree that it involves prejudgments (usually negative) about members of a group.

Belief on the other hand is the psychological state in which an individual holds a conjecture or premise to be true. Because our beliefs are the primary determinant of what we do and feel, and even what we perceive, all prejudice can usually be traced to belief systems. Both beliefs and prejudices themselves change with time.

Twentieth century Britain seen many prejudices enacted against differing races and religions. In the early part of the twentieth century British people were convinced that Irish immigrants were not as good as themselves, in later years, Jamaicans, Pakistanis and Nigerians have taken that role. These beliefs have in turn also been expressed about Catholics, Jews and more recently Muslims.

Just as we look back at cultural practices of ancient Rome with repulsion, future generations will probably look back at these prejudices with similar reactions. It is impossible for us to try and understand the Roman thinking that feeding Christians to lions was acceptable as a spectator sport. These beliefs were accepted two thousand years ago as these people were seen as a threat to the society that existed then. And they were probably right. History has decided that Christian religion would displace the Roman deities and their ministers would give rise to their own prejudices in turn,

especially in the period after the reformation.

So, a belief is really just a statement about a perceived reality that we individually experience as the truth. But, in fact, no belief describes the truth about reality. Without exception, beliefs are arbitrary interpretations of events by individuals. Physical objects and events certainly occur in the world, but the meaning that we give the events exists only in our minds, not in the material world.

If this is so, why is the prejudice against facial disfigurement so strong and why has it survived the ages?

At the outset, it would be easy to blame the stigmatisation of people with facial disfigurement on the emphasis that our modern image conscious society places on physical appearance. There is continual pressure, through media and other marketing tools for people of every age to conform to what is a perceived normal appearance. However, throughout the centuries, facial beauty has being perceived by many cultures as a human quality that provides a sensory experience of pleasure or goodness. Beauty has generally has been associated with that which is good and ugliness has been associated with evil. The Byzantine Emperor was considered God’s Vice-Regent on Earth and his beauty was taken as an essential complement to the perfection of Heaven. For this reason, many deposed emperors were facially disfigured by being

blinded or having their noses cut off to disqualify them from ever reclaiming the throne. During this period of history, society believed that facial “disfigurement” involved the entity being out of balance and harmony with nature and ugliness engendered a deeply negative perception of a person. This simplistic approach to ugliness and by association to facial disfigurements is still reinforced today at every stage by the media and by our education system.Consider our current classic children’s fairy tales, where the Ugly Sisters equate ugliness with evil and Cinderella with all things wonderful or indeed the tale of the Sleeping Beauty or the evil old witch in Hansel and Gretel. It is also reinforced on our TV screens (Ugly Betty) and with film and video villains such as Freddy (in Nightmare on Elm Street) and John Merrick (in Elephant Man).

If film makers or novelists were to treat race or sex in the way that they presently portray beauty or ugliness they would probably be subject to society’s revulsion and possible legal prosecution. Then why is society still disrespectful and uncompassionate to people who are usually not contributory in any way to their condition?

What causes us to turn away in revulsion from a person with a congenital, traumatic, or malignant facial condition rather than being compassionate and comforting them?

Symmetry of facial form leads to a person having more sexual partners and more satisfactory relationships and this is similar across every culture. In fact, if facial symmetry as a means for determining beauty has indeed an evolutionary basis, then this would explain why it is present in every human culture and even suggests our stigmatisation of facial disfigurement may actually be innate. This would happen if there was an evolutionary benefit to society to allow it to remain in every culture across so many millenniums.

Many scientists now believe that this revulsion may be an innate defense mechanism designed to protect society against disease and bad genes. It is well known that a three month old baby will smile and develop a bonding relationship quicker with a symmetrical face than they will with their own mother. This is probable evidence

www.cosmeticnewsuk.com 17

FACIAL DISFIGUREMENT

that this is not learned behaviour. A recent experiment by the BBC Inside Out team demonstrated presenter Julia Hankin made up with tattoo ink by a make-up artist - to give the appearance of a prominent port wine stain. In the course of the programme she took a seat on a busy bus route. It took 65 minutes before someone would sit next to her. Later, on the same journey with the make-up off, it was a very different story and someone took the seat next to Julia after about 30 seconds. Professor Nichola Rumsey, from the Centre for Appearance Research at the University of West England performed similar research on the London tube and found that people chose not to sit next to someone when they had a disfigurement on their face.

Psychologists like Valerie Curtis, a behavioral scientist at the London School of Hygiene and Tropical Medicine believe that the emotion of disgust is similar to fear. “Fear evolved to keep you away from large animals that want to eat you from the outside,” but “disgust evolved to keep you away from smaller animals that kill you from the inside.”

Our subconscious minds constantly scan the environment for signs of potential diseases, she says. If we see one, disgust kicks in and we avoid that object or person like the plague. It appears that even if we

know these people are perfectly healthy, our minds are responding to them as if they’re not.

So is there anything we can do to change our behavior? Education is probably a good start. We should strive to make atypical appearance more familiar and mundane, possibly following the lead set by Channel 4 and showing people with these types of appearances on television more often. As doctors we must respect and give supportive care to patients with facial disfigurements. For this reason, I have provided an extensive list of specialist organisations such as Changing Faces or the Disfigurement Guidance Centre in the United Kingdom who provide support people living with facial disfigurement and offer advice on all types of treatment. It’s important for parents to learn about their child’s condition and not to be afraid to ask their consultant as many questions as possible. Being better informed about your child’s condition will help them to learn how to cope with it.

There are also easy-to-learn, practical skills to help parents overcome some of the common challenges and uncertainties they may face.

Children start becoming curious about their appearance from an early age and learn from watching their parents deal with challenging situations.

Disfigurement support groups offer support, information and advice on specific conditions that can cause disfigurement.

BELL’S PALSY SUPPORT Bell’s Palsy Association The only UK-registered charity dedicated solely to providing help and information to people with Bell’s palsy.

FACIAL PALSY UK Charity supporting people who are affected by facial paralysis.

BIRTHMARK SUPPORT The Birthmark Support Group A UK-based support group for anyone with a birthmark.

BURNS SUPPORT The Children’s Burns Trust The Children’s Burns Trust is committed to providing support for burn- and scaldinjured children and their families.

CLEFT LIP AND PALATE SUPPORT Cleft Lip & Palate Association (CLAPA) CLAPA is the only UK-wide voluntary organisation specifically helping those with, and affected by, cleft lip and palate.

CRANIOFACIAL CONDITIONS SUPPORT Support for those affected by craniosynostosis and associated conditions.

18 www.cosmeticnewsuk.com

THE CRANIOFACIAL SOCIETY A society for the study of cleft lip and palate and other craniofacial anomalies.

DISFIGUREMENT SUPPORT Changing Faces Support for people who have disfigurements of the face or body from any cause.

EPIDERMOLYSIS BULLOSA SUPPORT DEBRA A UK charity for people with the genetic skin blistering condition epidermolysis bullosa (EB).

NEUROFIBROMATOSIS SUPPORT The Neuro Association Help, support and advice for those affected by either form of neurofibromatosis and their families.

PROTEUS SYNDROME SUPPORT Proteus Family Network A UK support group for families and individuals affected by Proteus syndrome.

RETINOBLASTOMA SUPPORT Childhood Eye Cancer Trust (CHECT) A UK-wide charity for families and individuals affected by retinoblastoma.

SCARRING SUPPORT The Scar Information Service Providing information on scarring, scar therapies and support organisations.

STURGE-WEBER SYNDROME SUPPORT Sturge-Weber Foundation Support and information on different aspects of Sturge-Weber syndrome, a rare neurological disorder.

TREACHER COLLINS SYNDROME SUPPORT Treacher Collins Family Support Group Support, advice and friendship for people with Treacher Collins syndrome and their families.

VITILIGO SUPPORT The Vitiligo Society Support for people with vitiligo and their families in the UK and the Republic of Ireland.

XERODERMA PIGMENTOSUM (XP) SUPPORT XP Support Group Support for people with xeroderma pigmentosum and other related conditions and their families.

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SPECIAL FEATURE/BOTULINUM TOXIN ALTERNATIVES

A TOPICAL ISSUE

Dr Sotirios Foutsizoglou on whether Argireline® really offers a topical alternative to botulinum toxin Argireline® is the trade name for Acetyl Hexapeptide-3 , a peptide made up of six amino acids attached to the acetic acid residue, manufactured and patented by the Barcelonabased company Lipotec. Argireline was first introduced in 2006 as an alternative treatment to Botulinum Toxin type A promising satisfactory results in reducing wrinkles and lines around the forehead and eyes. Argireline can be administered externally to the skin in the form of creams, lotions, serums, body milks, eye creams, gels, or emulsions making it appealing to those with needle phobia or those on anti-coagulants (e.g. coumarins) or antiplatelet drugs (e.g. Clopidogrel). When applied to the skin, Argireline relaxes facial tension leading to the reduction in facial lines and wrinkles with regular use. According to studies funded by its manufacturer it has been suggested that using 10% Argireline solution in cosmetics produces a reduction in the depth of wrinkles by up to 27% after 30 days of treatment.

Depth of wrinkles was evaluated by taking silicon imprints of the wrinkles around the eyes. Silicon imprints were measured by confocal profilometry. At the cellular level Botulinum Toxin A (BTA) paralyses the muscle by selectively bloking acetylcholine release at the neuromuscular junction. BTA cleaves the protein SNAP-25 irreversibly, and therefore the SNARE complex cannot assemble. Argireline mimics the N-terminal end of SNAP-25 competing with the natural protein for a position in the SNARE complex, without breaking any of its components. If the SNARE complex is slightly destabilized, the vesicle cannot release neurotransmitters efficiently and therefore muscle contraction is attenuated, producing thus similar results to the Botulinum Toxin type A (BTA).

The great advantage of Argireline is that it is not toxin-based and is a milder (and cheaper) alternative to BTA which is particularly useful in cases of allergic reactions or sensitivity to the BTA. In addition, limited studies suggest that Argireline, used as a topical wrinkle reducing agent, is also a safe option provided that concentrations do not exceed 10%.

I have been using Argireline as a topical application on the skin, or most commonly as an injectable formulation in a sterile ampoule, as part of my Mesotherapy cocktails. I would describe its effectiveness in reduction of the visible facial lines and wrinkles very satisfactory, in particular when used regularly. My experience with this product lies mainly in its use on expression lines on the forehead, glabella and perioccular area (crow’s feet). Please note that I normally use 5% of Argireline with 5% of Leuphasyl in 2ml ampoules after Mesolift or Mesoglow treatments in order to achieve a mild, non-toxic Botox effect, especially in cases where BTA is contra-indicated. Leuphasyl helps moderate the release of acetylcholine during the SNARE complex by lowering the skin’s electrical charge in the applied area, making it more difficult for neurons to fire. I have found that the addition of 5% of Leuphasyl can achieve greater results than using 10% Argireline on its own.

Finally it is worth mentioning that facial musculature relaxing agents such as Argireline should be used with caution in the lower half of the face where skin toning is required instead, as theoretically it may contribute to facial sagging.

Indications: • Use only on expression lines on the forehead, glabella, periocular, barcode (lips). Do not apply on areas where skin toning is the aim.

• 4 weekly or fortnightly sessions followed by monthly maintenance.

• Argireline and DMAE must not be given together during the same session as each has opposite effect. Alternate and use them every other week interchangeably. Apply DMAE for the lower part of the face.

References 1. Lipotec S.A. Peptides & Delivery Systems (2006) “Argireline an antiaging peptide” Code: PD010/PD011 2. Dr. Senen Vilaro (2005) ”Study on anti-wrinkle effect of Argireline by confocal profilometry techniques” Advancell, advanced in vitro cell technologies. Ref: CT441a

Dr Sotirios Foutsizoglou is the founder of SFMedica.He is a member of the Royal College of Surgeons of England, the British College of Aesthetic Medicine and the European College of Aesthetic Medicine and Surgery. His work has been extensively published in numerous UK journals, magazines and newspapers.

He is also a member of the International Society of Hair Restoration Surgery (ISHRS) and performs hair transplant surgery in Harley Street, London. Dr Sotirios Foutsizoglou is also involved in teaching and training.

He is the senior trainer in facial anatomy and nonsurgical procedures with KT-Training Medical Aesthetics

20 www.cosmeticnewsuk.com

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BOTULINUM TOXIN ALERNATIVES/ IOVERA˚

Frotox

Dr Vincent Wong on the iovera˚non-toxic wrinkle treatment In a world of organic food and free-trade cotton, it’s only natural that there would be demand for health conscious aesthetics. The modern day yuppie doesn’t want a quick fix. They want to invest in themselves so that they look a bit better today and a lot better 20 years from now. As doctors, we want them to feel confident that their aesthetic efforts are in tune with their personal health goals and philosophies. This is why I feel that the makers of iovera˚, got it all right. Myoscience seemed to read into the minds of our most demanding and savvy patients. They sought to create a device in tune with the future of aesthetics, one which not only improves appearance but doesn’t go against the preventative/ anti-ageing philosophies of health. It is for these reasons, I’m ecstatic to be a medical ambassador for the brand. Below, I’ve broken down for you all you need to know about iovera˚.

The Concept The world’s first toxin-free treatment for dynamic wrinkle reduction.

By using nothing more than the body’s natural response to cold, we are able to relax forehead wrinkles for up to three months.

The Desires An “organic” way to minimize the impact wrinkles have on our appearance. My patients have been asking for a toxin-free alternative, and iovera˚ finally addresses their desires for such a treatment. A wrinkle treatment that leaves the forehead relaxed and smoother in appearance immediately after treatment. With Iovera, patients see the final result upon leaving the office. We are able to tailor the treatment to the extent of the individual’s desire. It’s a huge advantage to know exactly the degree of improvement the treatment is giving you.

Some patients want to preserve certain natural movements and I can help guarantee this by allowing them to participate in mid-treatment evaluation. An aesthetic treatment which leaves nothing behind in the skin. Iovera allows the patient immediate aesthetic gratification without the uneasiness associated with other wrinkle treatments.

Since there is absolutely nothing injected into the skin, there is no mystery behind the function and the result… It’s just focused cold therapy. With nothing left behind, we don’t have to ponder the consequences of how the body will deal with the residual material. A less artificial-looking wrinkle treatment. No more peaked eyebrows or explaining to your friends why you decided to trade in wrinkles for your new found theatrical face.

My male patients are especially grateful for their new found, but discreet, facial youthfulness.

The Science Focused Cold Therapy is not a new concept. We have been using it for over 50 years in a variety of medical treatments. Myoscience has just refined the therapy for use targeting peripheral nerves and, in this case, the facial nerve for aesthetic purposes. Using nitrous oxide, we know that we cannot cause injuries to the nerve we are targeting beyond 2nd degree Wallerian Degeneration. The way we know this is because the boiling point of nitrous oxide is -88.5 C. In order to achieve more than 2nd degree Wallerian Degeneration, we must be able to produce temperatures below -140 C. Therefore, it is impossible to ever get close to damaging the nerve body with iovera˚. For those of you who are not familiar with the Wallerian Degeneration scale, it is one which allows us to assess nerve damage.

There are five levels and levels one and two are completely reversible as they do not affect the nerve body. More specifically, extensive studies have shown that 2nd degree Wallerian Degeneration affects only the myelin sheath and the axons. Hence, we know that we are only inhibiting the conduction of nerve impulses and not damaging the nerves. Furthermore, we know that this type of effect on the nerve is reproducible and has no long-term side effects. Using iovera˚ technology, we now have a gentle, safe and elegant device to temporarily inhibit the motor nerves responsible for forehead and glabellar dynamic wrinkles.

The Treatment After marking and anaesthetising the area, the patient is placed in a supine position for treatment. The 30-minute treatment consists of several cycles of cold therapy in each temple. Focused cold therapy involves the use of a three-probe 27 gauge closed-end needle tip. This said, the treatment is considered minimally invasive, and even gentle, to the skin. Patients report a light discomfort as the needles are introduced.

A pressure sensation is most often described while the device is creating a cold zone around the nerve. This sensation is short-lived and is most often easily tolerable. Some patients complain of a slight headachelike sensation for about 10 seconds after the needles are removed. If experienced, most described it as “ice-cream headache like.” You will see an immediate reduction in forehead and glabellar wrinkles. The brows will appear naturally relaxed, and the patient will be unable to make angry or aggressive facial gestures. The temple area may be a bit swollen and tender to touch. This sensitivity usually goes away within hours to a day after treatment.

Why I think this is the future?

I have been using iovera˚ since last April and have treated over 40 patients. I am thrilled with the device, treatment and outcomes - and, more importantly, so are my patients! Over the years, I’ve seen way to many ‘over-done’ faces. These days, people want natural-looking alternatives to more dramatic and aggressive procedures. iovera˚ fills both the need for something more “organic” in nature and a softer aesthetic result.

Dr. Vincent Wong is an advanced medical aesthetics practitioner and the founder of La Maison de l’Esthetique. He is a member of the European College of Aesthetic Medicine and has extensive research experience in plastic surgery and dermatology.

He has presented his work at several national and international conferences, including those hosted by the British Association of Plastic, Reconstructive and Aesthetics Surgeons (BAPRAS) and the British Association of Dermatology (BAD).

22 www.cosmeticnewsuk.com

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CLINICAL STUDY

IN COMPARISON We summarise the results of a clinical study, published in the Journal of Cosmetic Dermatology, comparing Uma Jeunesse and JUVÉDERM® Ultra 3 Introduction Absorbable soft-tissue dermal implants are used to temporarily fill facial lines and wrinkles and augment contour deformities. Facial aging causes cellular and anatomic changes, resulting in the loss of soft-tissue volume. Today we have the ability to address these changes with the utilization of dermal fillers. Over the years, emergence of minimally invasive injectable implant-based facial enhancement as a viable alternative to reconstructive surgery has revolutionized aesthetics. This has seen the appearance on the market of several injectable implants that have all their merits and demerits. There are several varieties of implants available based upon hyaluronic acid (HA), collagen, methyl cellulose, hydroxyapetite, etc. HA– based implants have been the most widely used and have gained acceptance primarily because of the high biocompatibility of HA over and above other substances. HA dermal fillers are the most popular, nonpermanent injectable materials available to physicians today for the correction of soft tissue defects of the face. This material provides an effective, noninvasive, nonsurgical alternative for correction of contour defects of the face because of its ability to bind water and ease of implantation. HA dermal fillers are also safe and effective.

The desire of the new generation to turn back the clock while enjoying an active lifestyle has contributed to the popularity of these fillers. As a result of this popularity, the literature has seen an expansion of published works documenting experience in the use of dermal implants with respect to effectiveness as well as adverse events. Goldberg1 has described the recent breakthroughs in dermal fillers for soft-tissue augmentation.

Gold2 has reviewed treatment of wrinkles using dermal fillers.

Beer3 has discussed the use of dermal fillers and their combinations in facial rejuvenation. Grunebaum et al.4 have described the risk of alar necrosis associated with dermal filler injections. Hirsh and Stier5 have discussed complications and their management in cosmetic dermatology using thesemtechniques. Taylor et al. have conducted a randomized controlled trial to investigate the safety of nonanimal HA in patients with skin of color. They concluded that in patients with skin of color, nonanimal HA dermal fillers are safe for the correction of moderate to severe facial folds and wrinkles, with no immunogenicity or keloid formation and only mild to moderate adverse events occurring around the injection site.6 Grimes et al. have also investigated the safety and effectiveness 24 www.cosmeticnewsuk.com

ABSTRACT TITLE Comparative study of a new dermal filler Uma Jeunesse and JUVÉDERM® AUTHORS Peeyush Sharma, MD, FRCS(Eng.) and Siroj Sharma, BSc, British Institute of Aesthetic Medicine PUBLISHED Journal of Cosmetic Dermatology CONFLICTS OF INTEREST No financial support was received by the authors for this academic work. Cambridge Medical Aesthetics Ltd UK made injectable products available for this study.

KEYWORDS crosslinking, dermal filler, facial filler, hyaluronic acid, intradermal injection, Juvederm Ultra, lidocaine, longevity, Uma Jeunesse, wrinkles

of HA fillers in skin of color and conclude that these fillers were well tolerated and demonstrate effectiveness throughout the trial period. Furthermore, the fillers provided smooth, natural-looking wrinkle correction in darker skin types.7 Alexiades-Armenakas8 has discussed the safety of the dermal fillers. Levy et al. have conducted a split-face study comparing a dermal filler containing pre-incorporated lidocaine with a standard HA dermal filler. They conclude that patient acceptance was much greater with the product containing lidocaine.9 There are several comparative trials on the existing dermal filler implants 10–14 but not many on new implants.

Technological advances continue in the design of injectable dermal implants. A new HA-based dermal filler implant has recently become available. This product uses a new technology of molecular engineering, according to the claims of the manufacturer, to reduce side effects, last longer in tissues, and increase lifting power. We had the opportunity to investigate the safety, effectiveness, and longevity of this product in comparison with one of the currently available dermal fillers on the market in a clinical trial.

Table 1 Details of subjects included in the study

Patients and methods

Results

Uma Jeunesse and Juvederm Ultra 3 were injected in a split-face study on 17 healthy volunteers, whose ages ranged from 33–58 years. There were 14 women and three men with medium to deep nasolabial folds. All subjects randomly received either Uma Jeunesse or Juvederm Ultra 3 on one half of their face. Patients were followed up for nine months. Patient characteristics are presented in Table 1.

All patients had a good outcome in that there was an over 90% correction of NLF with both products under investigation. However, the adverse events and longevity results for the two products were somewhat different. Injector and patient assessment data immediately after injection are presented in Table 3. Post-injection discomfort was defined as pain or discomfort from 1 to 6 h following injection. A total of 17 individuals were treated with both products, randomly assigned to the right or left NLF.

All subjects were treated with both products, Uma Jeunesse (UJ) and Juvederm Ultra 3 (J), randomly assigned to the right or left nasolabial fold (NLF). Injector assessment indicated mean injection pain, pain of massaging the injected area, and post-injection discomfort. A visual analogue scale was used by injector and patients (based on a scale of 0 = no pain to 10 = extreme pain).

Products were injected by a senior physician.

The areas treated were medium to deep NLF. The implant was injected into the deep dermis using a 27-G, 13-mmlong needle (Microlance, Becton Dickinson, NJ, USA). NLF are considered representative of moderate to severe facial wrinkles and folds, and thus data collected from these studies are accepted to support the approved indications for use for dermal fillers. 15 Patients were assessed at 1 week and 1, 3, 6, and 9 months using 2D images. Images were assessed by two independent observers

Comparison of injection pain assessment by injector for the new product (UJ) (2.94 ± 2.2) with the same for the reference product (J) (2.23 ± 1.3) showed no significant difference (P = 0.258).

Similarly injection pain assessment by patient for the new product (UJ) (3.35 ± 1.4) was compared to the reference product (J) (2.88 ± 0.9) and again there was no significant difference (P = 0.238).

Injector assessment of mean pain of massaging the injected area for the new product (UJ) (3.29 ± 2.1) vs. the reference product (J) (2.06 ± 1.2) did however show significance (P = 0.04). Patient assessment of the same for the new product (UJ) (3.17 ± 1.9) and the reference product (1.65 ± 1.4) also reached significance (P = 0.014). Injector assessment score of post-injection discomfort for the new product (UJ) was 1.29 ± 1.1 and for the reference product 3.1 ± 1.9 (P = 0.003). Finally, patient assessment score of postinjection pain for the new product (UJ) was 1.23 ± 0.8 and for the reference product 2.9 ± 1.6 (P = 0.0004). Early adverse effects were defined as those occurring within 3 days of treatment and lasting under 4 weeks. The data are presented in Table 4.

Swelling after injection occurred with both products although somewhat lower with the new product (UJ) (41.1%) than the reference product (88.2%), there being no statistical difference (Table 4). Similarly, postinjection redness, discoloration, pain, beadiness, migration, and bruising were much less with the new product than the reference product, but the data did not reach significance. In the case of discoloration (P = 0.0653), migration (P = 0.0941), and bruising (P = 0.0863), the P values were low

Table 3 Injector and patient assessment scores during and immediately after injection mean ± SD: 0 = no pain; 10 = extreme pain.

www.cosmeticnewsuk.com 25

CLINICAL STUDY

Table 4 Adverse events observed 10 hours or more following injection: Uma Jeunesse (UJ) and Juvederm (J)

and close to what we accept as significant for this study (0.05) but not quite there. However, postinjection itching (P = 0.0046) and numbness (P = 0.0148) were significantly lower with the new adverse events occurred in far fewer patients, and their intensity was less severe in the new product (UJ) group than the reference product group (Table 4).

All patients were followed up for at least 9 months, and the longevity of the product was assessed by the loss of aesthetic effect in percent using a five point scale. Both products achieved an aesthetic correction over 90%. Assessment of disappearance of the implant was done by palpation

and comparison to the volume after injection. Degree of reappearance of NLF compared to the pre-injection state was documented as percentage loss of aesthetic effect. Table 5 shows results of the follow-up.

Conclusion

The new dermal implant Uma Jeunesse Is a safe and patient-friendly product, which resides in the tissues for longer with maintenance of aesthetic effect over and beyond six months, reaching nine months in over 80% of patients, and Juvederm injection is less painful.

Table 5 Loss of aesthetic effect with the two products over time presented as percentage of observations in all subjects (mean ± SD)

REFERENCES 1 Goldberg DJ. Breakthroughs in US dermal fillers for facial soft-tissue augmentation. J Cosmet Laser Ther 2009; 11(4): 240–7.

2 Gold M. The science and art of hyaluronic acid dermal filler use in esthetic applications. J Cosmet Dermatol 2009; 8(4): 301–7.

3 Beer K. Dermal fillers and combinations of fillers for facial rejuvenation. Dermatol Clin 2009; 27(4): 427–32.

4 Grunebaum LD, Bogdan Allemann I, Dayan S et al. The risk of alar necrosis associated with dermal filler injection. Dermatol Surg 2009; 35(Suppl. 2): 1635–40.

5 Hirsch R, Stier M. Complications and their management in cosmetic dermatology. Dermatol Clin 2009; 27(4): 507–20.

6 Taylor SC, Burgess CM, Callender VD. Safety of nonanimal stabilized hyaluronic acid dermal fillers in patients with skin of color: a randomized, evaluator-blinded comparative trial. Dermatol Surg 2009; 35(Suppl. 2): 1653–60. 124 7 Grimes PE, Thomas JA, Murphy DK. Safety and effectiveness of hyaluronic acid fillers in skin of color. J Cosmet Dermatol 2009; 8(3): 162–8.

8 Alexiades-Armenakas M. Safety of dermal fillers. J Drugs Dermatol 2009; 8(3): 214–5.

9 Levy PM, De Boulle K, Raspaldo H. A split-face comparison of a new hyaluronic acid facial filler containing pre-incorporated lidocaine versus a standard hyaluronic acid facial filler in the treatment of naso-labial folds. J Cosmet Laser Ther 2009; 11: 169 73.

10 Pinsky MA, Thomas JA, Murphy DK, Walker PS. Juvederm injectable gel: a multicenter, double-blind, randomized study of safety and effectiveness. Aesthet Surg J 2008; 28(5): 596–7.

11 Weinkle SH, Bank DE, Boyd CM et al. A multi-center, double-blind, randomized controlled study of the safety and effectiveness of Juvederm injectable gel with and without lidocaine. J Cosmet Dermatol 2009; 8(3): 205–10.

12 Narins RS, Brandt F, Leyden J et al. A randomized, double-blind, multicenter comparison of the efficacy and tolerability of Restylane versus Zyplast for the correction of nasolabial folds. Dermatol Surg 2003; 29(6): 588–95.

13 Carruthers A, Carey W, De Lorenzi C et al. Randomized, double-blind comparison of the efficacy of two hyaluronic acid derivatives, restylane perlane and hylaform, in the treatment of nasolabial folds.

Dermatol Surg 2005; 31(11 Pt 2): 1591–8; discussion 1598.

14 Raspaldo H, De Boulle K, Levy PM. Longevity of effects of hyaluronic acid plus lidocaine facial filler. J Cosmet Dermatol 2010; 9: 11–6.

15 FDA. Executive summary on dermal filler devices, 18th November 2008.

26 www.cosmeticnewsuk.com

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NUTRITION AND BODY SHAPING

THE BIG ISSUE Kim Pearson on the importance of addressing diet with liposuction patients Liposuction procedures have seen a sharp growth in popularity over recent years. According to a survey carried out by WhatClinic.com over the last 12 months there has been a significant 75% rise in enquiries for liposuction treatments.

A common misconception amongst patients is that liposuction is a quick fix procedure to lose weight by reducing excess body fat but quoted in the Daily Mail, consultant plastic surgeon Patrick Mallucci states: ‘Liposuction is for sculpting, not for losing weight, and works best on those who need it least – they eat a healthy diet and exercise as much as they can but are left with a few stubborn areas of fat. We can only work with what’s there and aim to improve it and the same principle applies post-surgery – consume more calories than you burn and your body will store the excess as fat.’

A survey published in the Journal of the

Kim Pearson Kim Pearson qualified as a nutritionist at London’s Institute for Optimum Nutrition in 2008 and has worked in the field of nutrition, diet and health for over eight years. Kim works in clinical practice to improve wellbeing and health issues of her clients through nutrition, her areas of speciality are fat loss and body contouring, skin and anti-ageing.

Frequently featuring in the national media, Kim writes articles and provides professional comment for a range of magazines, newspapers and medical journals and has also featured on national television and radio.

Kim speaks at medical and beauty conferences and trains health care professionals in nutrition and diet.

Kim is a full member of BANT (British Association of Applied Nutrition and Nutritional Therapy) and the Guild of Health Writers.

American Society of Plastic Surgeons revealed that 80% of liposuction patients said they were satisfied with the results of their surgery. However, in that same survey, nearly half of those patients said they re-gained weight in subsequent months; not because the procedure didn’t work, but because they didn’t take the necessary steps to maintain their new figure. A 2011 study by Teri L. Hernandez et al. at the University of Colorado School of Medicine (1), set out to examine whether fat returns after removal by liposuction and if so, where it returns to. 32 healthy, non obese women were enrolled onto the study with disproportionate adipose tissue depots on the lower abdomen, hips, or thighs. Study participants agreed to not make lifestyle changes whilst enrolled.

The study found that ‘after one year … following suction lipectomy, body fat was restored and redistributed to the abdomen’.

Research shows that hormones strongly influence where in the body fat is deposited. For example, the stress hormone cortisol is strongly linked to increased abdominal fat storage (2) whilst oestrogen is largely responsible for weight gain on the lower extremities, namely the hips, thighs and buttocks (3).

When fat cells have been removed from a specific site, the removal is permanent and the body is able to regain far less weight in the same area. Experience has shown me that, if the body cannot store fat in the same area as it did before surgery, it appears to accumulate over time in a site with close proximity to the treated area.

Working in the medical aesthetics industry, I consult individuals both before and after liposuction surgery to offer support and advice on how best to optimise their results and prevent possible weight gain post-surgery. From time to time I see individuals who have

not taken the necessary diet and lifestyle steps to maintain the results of their procedure, referred to me only after they have re-gained weight in the months or years post liposuction. The individuals I see who have gained weight often suffer from undesirable pockets of localised fat in areas that were never a problem before surgery. I believe that it is essential that patients are made aware that diet and lifestyle factors that play a fundamental role in the optimising and maintaining of results following liposuction in the long term, and avoiding perhaps one of the most distressing side effects, irregular weight gain.

Below are photographs of a 35 year old female who had Vaser liposuction on her lower abdomen. Following her liposuction procedure she fell pregnant with her first child and gained weight resulting in a localised fat deposit on her upper abdomen. I worked with this client to help her lose 9kgs using a protein based diet, low in carbohydrates and calories with optimal amounts of fresh vegetables, essential fats and micronutrient supplementation tailored to the individual. The client lost 9cm from the circumference of her upper abdomen.

She was delighted with the result and felt that the area now resembled what it had done post surgery.

before

28 www.cosmeticnewsuk.com

after

The photo below shows a 64 year old female who had Vaser liposuction on her lower back and flanks one year prior to seeing me. As she gradually gained

weight following surgery fat deposited on her upper back - clearly visible in the picture. She claims that this was not a problem area prior to having liposuction.

With dietary intervention this client has so far lost 10.3kgs and vast improvements are showing in the appearance of the fat on her upper back.

In addition to dietary intervention designed to reduce body fat, these clients have also been educated as to how they should eat to maintain their weight long term and of course, exercise is also recommended.

Last year, a study published in the Journal of Clinical Endocrinology (4) demonstrated that whilst liposuction was effective in reducing and maintaining subcutaneous abdominal fat, subjects who did not exercise showed a significant 10% increase in visceral fat. Researchers concluded that the compensatory increase in visceral fat was counteracted by physical activity.

Ideally, it is always best for nutritionists to work with liposuction patients to help reduce their body fat prior to surgery to optimise the safety results of the procedure. According to Mr Bryan Mayou, consultant plastic surgeon at The Cadogan Clinic (www.cadoganclinic.com) and member of the British Association of Aesthetic Plastic Surgeons ‘for aesthetic liposuction procedures, it is optimal to operate on someone who is slim but with localised areas of fat. I speak with patients about their weight and diet prior to surgery. I prefer people to see me at the right time, so if they express a

desire to lose weight I put in touch with someone who can help with their diet and encourage them to delay surgery until they have reached their desired weight.’

However, in reality, many individuals are motivated to lose weight, improve their diet and start exercising following surgery. It appears to serve as a kick start to a healthy new regime.

I recently worked with a 45 year old male who had Vaser liposuction on his chest, flanks and upper and lower abdomen. He was referred to me shortly after having the procedure as he still had excess weight to lose. He was happy with the results of his treatment but following dietary intervention, he has lost 10kgs and this has significantly improved the definition of his abdomen.

Mr Mayou points out that ‘the heavier a patient is and the more fat that is removed, the greater the risks, so it makes sense to lose weight before undergoing liposuction. However it is important to remember that there are rare indications where it may be appropriate to operate on larger patients.

For example, an obese patient who struggles to walk because their thighs rub together may benefit from removal of fat on the inner thigh.

This can allow them to walk more comfortably and increase their chances of becoming more active and subsequently losing weight.’

I believe that when carried out on a patient who eats well, exercises regularly and has an optimal body weight, liposuction can significantly improve the appearance of stubborn pockets of subcutaneous fat.

It can also motivate

individuals to improve their diet and increase their physical activity. It is vital patients understand that liposuction is not a weight loss procedure and that in order to maintain their results, they need to commit to a healthy diet and lifestyle long term. If they do not, they not only risk regaining new pockets of subcutaneous fat, they could potentially be putting their cardiovascular health at risk.

References 1. Teri L. Hernandez et al (2011) Fat Redistribution Following Suction Lipectomy: Defense of Body Fat and Patterns of Restoration. Obesity, Jul;19(7):1388-95.

2. Moyer AE, et al (1994) Stress-induced cortisol response and fat distribution in women.

Obes Res. May;2(3):255-62.

3. Power ML, Schulkin J (2008) Sex differences in fat storage, fat metabolism, and the health risks from obesity: possible evolutionary origins.

Br J Nutr. May;99(5):931-40.

4. Benatti F, et al. (2012) Liposuction induces a compensatory increase of visceral fat which is effectively counteracted by physical activity: a randomized trial. J Clin Endocrinol Metab.

Jul;97(7):2388-95.

www.cosmeticnewsuk.com 29

Q & A | DR ROBERTO VIEL

A GROWTH MARKET We talk to Dr Roberto Viel from the London Centre for Aesthetics about the growing trend for penoplasty Last year, Dr Roberto Viel performed penoplasty on at least five men a week – a total of around 300 cases, an interesting statistic when you take into consideration that in the same period of time, nationally, just 323 men had male breast reduction.

The procedure involves making an incision above the base of the penis, releasing the penile suspensory ligament.

This allows the penis to be brought forward, thereby lengthening it externally by typically 1-2 inches. Men with prominent pubic fat pads will gain more length; if for example they have a two-inch fat pad, and 1.5 inches is removed, the additional 1.5 inch gain will be supplemental to the extension gained by releasing the suspensory ligament. This increase in length is in the flaccid position only and some men may find that the angle of the erection may be slightly lower. Many men have circumcision performed at the same time, as this avoids swelling of the foreskin, which can last for several weeks.

The increase in girth, involves a small amount of liposuction of the stomach or thigh areas to collect fat, followed by re-introduction of the fat by injection along the shaft of the penis. The usual increase in girth (circumference) is between 1 to 2 inches. The fat injection procedure avoids incision scars and because it is a simpler technique, the recovery time is shorter. Furthermore, the benefits of abdominal liposuction will enhance the patient’s appearance.

Possible post-operative fat re-absorption and nodule formation can be minimised by limiting the amount of fat injected at one time. The girth enlargement is restricted to be slightly bigger than the tip. The enlargement of the penis will be evident in both the flaccid and erect states.

We talk to Dr Viel in more detail…

Cosmetic News: Are the majority of guys’ issues psychological or physical?

Dr Roberto Viel: For most, it is not a big physical problem: they simply feel selfconscious in the gym changing room or when wearing swimming trunks. They want the lengthening operation to make them feel more confident, although those opting for the girth enlargement can expect benefits for a partner too! It’s clear this problem has been neglected by the medical profession for a long time, 80% my clients want an increase in both girth and length.

that looks natural and will make sure a patient is completely aware of the results he will see, before committing to surgery.

The penoplasty can increase flaccid length by one to four inches and the circumference by about the same amount – but I won’t do anything unnatural. This can have a hugely beneficial effect on clients psychologically, as this is really all about the man and his own self-image and esteem.

CN: What are the dangers, this is quite a delicate area?

RV: Like all operations, penoplasty is not without complications, they are rare but can occur. These include infection, bleeding, collection of blood under the skin, known as haematoma or blood clot; however this occurs in less than 1% of patients and drains and heals spontaneously. In some cases with enlargement surgery the shaft may be asymmetrical or lumps may occur due to the position of the fat. Gentle massage

CN: Does anybody come to you with unrealistic expectations?

RV: Yes, and we send them away. We are very realistic about what we can achieve 30 www.cosmeticnewsuk.com

CN: What influence do you think the images men are seeing today is having on how they feel about their penis and what they want done?

RV: We have seen a huge increase in penoplasty. The media has the same influence on men’s as it does women, and since the David Beckham H&M campaign we have seen mammoth waiting lists for penoplasty in our clinics.

should normally resolve this problem.

There is no known effects to your bedroom performance. Your key organ is your brain and nobody can predict how you will react after surgery. We have, however, found that most men feel more confident about themselves. Penoplasty is now well established cosmetic procedure, having been performed for the last 10 years. It is both a safe and effective procedure and, with no foreign material or implants introduced, the complications are rare.

CN: Are there any follow-up procedures needed?

RV: The fat taken pre-operation is stored, so if there is fat absorption back into the body, fat is a natural substance so this does happen to a small 5 of the fat over time, you can pop in and be topped up! This is a quick procedure and works very effectively.

CN: If the fat is injected into the penis, does this mean the penis doesn’t get fully hard when erect?

RV: These procedures do not interfere with the normal functioning or sensitivity of the shaft.

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Stem and us

We find out how mesoestetic® has incorporated molecular biology into its new stem Cell cosmeceutical range threads plant stem cell extract to combat advanced signs of photoaging and repair skin damage caused by intrinsic factors, skin stress, or environmental exposure. The system uses nanoencapsulation where the active ingredient is encapsulated in liposomes to enhance ingredient penetration into the skin and achieve optimal results.

Home maintenance line stem Cell active growth factor (50 ml) Regenerative cream that combines the action of plant stem cells extract with that of growth factors to achieve skin restructuration from inside the cell. Growth factors are small fragments of biologically active proteins that belong to the cytokine group. These are key elements to intercellular communication and external control of cell reproduction mechanisms.

They can attract and guide the cells at the site where they are needed, and are involved in the generation of new cells by cell division.

A

s time goes by, skin cells gradually lose their ability to perform their functions. From the age of 30, the natural cell renewal process slows down. Structural protein synthesis (synthesis of collagen and elastin) decreases, diminishing the cohesion of the skin and resulting in the formation of wrinkles and the loss of skin tone. The skin becomes thinner and loses density, elasticity and luminosity, while spots and expression lines start to appear. mesoestetic® has developed a new cosmetic treatment designed to protect existing skin cells by stimulating the skin’s natural self-repair process: stem Cell. The line is formulated with nanoencapsulated plant stem cells and includes the beauty salon treatment and a line of skin care products for home use.

Stem cells

These are progenitor cells that are autorenewable by means of mitosis, and can regenerate one or more kinds of differentiated cells. There are adult stem cell populations in the various tissues responsible for periodic renewal and regeneration and repair when damage occurs in them (acting as cell reserve). Stem cells can divide, without losing their properties, and generate new cells. They are the mainstay for the cell renewal process, so their protection and restoring is essential. For each protected stem cell, thousands of epidermal cells may be renewed, repairing the effects of skin aging. Skin stem cells are the direct precursors of the cells found in the different dermal layers. Thanks to their ability to differentiate, they can regenerate aged tissues. The plant stem cells extract is obtained by means of a biotechnology process. It is characterised by being rich in phytonutrients and proteins. Several clinical trials performed with this active substance have revealed the following properties: The plant stem cells extract has the ability to effectively protect and reactivate our own dermoepidermal stem cells, strengthening the connective tissue structure and improving skin quality and texture. By stimulating the activity of fibroblasts and keratinocytes in collagen and elastin output, the plant stem cells extract exerts a strong antiaging and antiwrinkle effect on the skin.

The stem Cell system

The aim of the stem Cell system is to support skin cells by strengthening their self-repair ability. All stem Cell products contain highly concentrated 32 www.cosmeticnewsuk.com

stem Cell nanofiller lip contour (15 ml) The first filling effect cream based on plant stem cells extract and hyaluronic acid specifically designed for the treatment of the delicate lip contour area. This unique combination acts synergistically and provides a twofold effect: regenerator: the plant stem cell extract stimulates collagen and elastin production, prolonging cell life. filler: hyaluronic acid fills the thinner areas, providing support to the cells created.

Intensive treatment stem Cell serum restructuractive (5 viales de 3 ml) Ultraconcentrated serum with intensive renewal action. With 10% stem cell extract, it is a powerful starting treatment against cell aging, reversing the skin degradation process.

Stem Cell professional treatment is a simple and effective professional treatment for the face and neck that combines highly renewing and repairing products with an exclusive regenerative massage technique.

The treatment pack contains: • stem Cell serum restructuractive (5 units) Highly concentrated serum with intensive regenerating effect. Prolongs the life of skin cells repairing deep wrinkles.

Active substances: 10% plant stem cell extract • stem Cell crystal fiber mask (5 units) Crystal fiber is a material for medical use based on 3D nano-fibres, 100% natural, safe and hygienic. It includes two independent pieces that adapt perfectly to the face and neck physiognomy, performing an occlusive effect that improves the permeability and efficacy on carrying active substances.

Intensive regenerating effect.

Active substances: Plant stem cells extract; Vitamins C and E: They show a regenerating anti-free radical action, preventing degeneration of skin tissues; Aloe Vera: It stimulates cell growth by supplying micronutrients, leading to repairing, restructuring and soothing actions and relieving skin microlesions.

• stem Cell active growth factor (50 ml) For home maintenance of the results obtained in clinic.

To be in with a chance to win some of the stem Cell products visit the Cosmetic New S Facebook page.

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SPOT ON

We speak to Debbie Thomas about the DERMACEUTIC Spot Peel According to advanced skincare specialist, Debbie Thomas, uneven

The simple, three-step procedure starts with two weeks of pre-peel

pigmentation is a widespread skin complaint in the autumn months.

prep using Light Ceutic, a lightening cream containing glycolic acid to

In most cases, this is directly related to sun exposure in the summer

exfoliate the skin to encourage deeper penetration of the peel, phytic

months. Hyperpigmentation can affect all ages, all ethnicities and

acid which has antioxidant and anti-inflammatory agents and vitamin

all skin types. It is simply the body producing too much melanin

C which protects against oxidative stress and helps to regulate pigment

(the natural pigment that gives colour to the skin) in response to UV

production.

exposure, hormonal fluctuations or trauma to the skin (such as acne).

This can occur all over the body, but the most common areas are the

The Dermaceutic Spot Peel is undertaken in clinic and generally lasts

forehead, cheeks, upper-lip, chin, hands and chest (where skin is

15-30 minutes. The skin is cleaned and primed with a special pre-peel

exposed to the sun).

cleanser. The transparent peel is applied all over the face or affected area/s. It stays on the skin for 8-12 hours and has to be removed at

Hyperpigmentation tends to get worse with age because the skin is less

home with water.

able to properly distribute melanin, increasing the risk of uneven skin tone. Debbie says, “Irregular pigmentation is now the most common

The Dermaceutic Spot Peel contains:

‘ageing’ skin complaint from my customers. Whether it is melasma or

Mandelic acid

post-inflammatory hyperpigmentation, customers who are 40-plus

Idebenone

tend to have the worst cases. In recent years I have also seen a rise in

Emblica

people coming to me with actinic keratosis and so I wanted to offer a

Retinol and

peel that could tackle this problem too.”

Salicylic acid

The National Institute for Health and Clinical Excellence (NICE)

There is minimal

estimates that more than 23% of the UK population aged 60 and above

down-time, only

has actinic keratosis - thick, scaly or crusty patches of skin which is the

two days of pink-

result of skin damage from years of sun exposure.

looking skin while

The Dermaceutic Spot Peel treats pigmentation spots, melasma

the skin repairs

and chloasma (melasma that occurs during pregnancy). It is also

itself. The healing

highly advised in cases of actinic keratoses and post-inflammatory

process can be

pigmentation (discolouration of the skin that follows an inflammatory

accelerated with

wound, rash or pimple).

the use of a repair cream and in all cases patients should use UV protection. The results can also be maintained if the Spot Cream is used at night for at least one month following the peel (only from day four, post peel). Spot Cream contains de-pigmenting and exfoliating agents - mandelic acid, emblica, retinol and salicylic acid. Customers also have the option of moving onto the de-pigmenting concentrate Yellow Cream, which regulates melanin biosynthesis (inhibition of tyrosinase).

Patients with moderate pigmentation will notice a dramatic reduction in their pigmentation after one treatment and their skin will be revitalised and refreshed. For those with stubborn pigmentation a second peel may be required. Results may vary

BEFORE

AFTER

34 www.cosmeticnewsuk.com

according to the patient.

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www.cosmeticnewsuk.com 35

PRODUCT NEWS SYNERON CANDELA

SCHUCO

Syneron Candela Launch New larger spot delivery systems for GentlePro

Schuco provide a new benchmark for skin needling technology

Syneron-Candela has introduced a faster way to treat patients with their new range of large spot delivery systems.

Without any compromise on energy, the new 20, 22 and 24mm spot sizes shorten laser procedure time by up to 28%, improve patient experience and help reduce any discomfort, ensuring ultrafast treatments with excellent results. The new larger spot sizes mean that the GentlePRO laser is more cost effective, allowing for more treatments in a shorter space of time. The new spot sizes are compatible with all GentlePRO laser systems and are available for both the Dynamic Cooling Device (DCD) or Air Cooling Compatible (ACC) configurations.

Schuco has developed the Revive Micro Needling System claiming to offer clinicians “the best possible control” when carrying out micro-needling treatments on their patients. The system with its almost silent, low vibration unit, has a broad range of needle cartridges and is designed for all situations, the technology featuring a ‘6 point cartridge’ tilting head mechanism assures virtually no skin drag. The Revive MN can be combined with Revive HAP a mesotherapy solution for intradermal injections which includes a unique form of revitalising ingredients, 1% Hyaluronic Acid and peptide complex, or the Meso Vytal Cell Boost range. Meso Vytal is a mechanised way of delivering active ingredients into the skin with minimal trauma and downtime to provide rejuvenation and refreshment to the skin whilst aiding in the reduction of wrinkle formation.

DMK

DMK announce arrival of Transgenesis DMK has launched a new skincare product: Transgenesis. Founder of DMK, Danné MontagueKing utilised the philosophy of Remove, Rebuild, Protect and Maintain when formulating the new product which contains a variety of potent ingredients including Red Caviar Enzymes, Tripeptides, Oligopeptides Glycosaminoglycans, Amino Acids, and Filaggrin Modulators. The product is paraben free with no artificial colours or fragrance.

MESOESTETIC

mesoestetic presents home performance mesoestetic Pharma Group has introduced a new home performance product range. The extensive range of cosmeceuticals for home use offers a high level of therapeutic response. The range contains 20 hygiene, facial care, sun protection and hair care products, that includes treatment products for all skin types and for aesthetic disorders such as dark spots, acne and cuperosis.

SKINADE

Skinade launches new micronutrient liquid formula Skinade has launched a new patent-pending drink that uses advanced technology and high quality ingredients to improve the skin. The formulation has been designed to deliver collagen and essential micro-nutrients in a liquid formulation, promoting high absorption and bioavailability. The launch of Skinade represents a different approach to skincare that works from the inside out. Active ingredients include: hydrolysed marine collagen, Vitamin C, Omega 3 & 6, MSM, Vitamin B complex and L-lysine (an essential amino acid). The UK manufacturers behind the brand claim that ‘Proven results from drinking Skinade daily include softer and more hydrated skin within just four to six days’.

36 www.cosmeticnewsuk.com

HEALTHXCHANGE

Healthxchange Pharmacy Introduces Aqualyx® to the UK for Intralipotherapy HealthXchange Pharmacy has introduced a new fat dissolving product into the UK for use with Intralipotherapy. Developed for the non-surgical reduction of subcutaneous adipose tissue, Aqualyx® is an injectable, gel-based aqueous solution, which dissolves fat and is biocompatible and biodegradable.

Aqualyx® is currently the only product available for intralipotherapy with a registered medical CE mark.

The product is now available to doctors and surgeons in the UK, exclusively via Healthxchange Pharmacy, It works by causing the dissolution of fat cells and the body then expels the released fatty acids naturally.

Aqualyx® has been available internationally for intralipotherapy since 2009, with over 2,000,000 vials being used in treatments across 49 countries worldwide. Aqualyx® was developed by Professor Pasquale Motolese, Vice President of the Italian Society of Aesthetic Surgery and Medicine. The product was presented at the Aesthetic Medical International Congress in Milan in 2004 and it is now available exclusively in the UK and Ireland from Healthxchange Pharmacy.

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MesoVytal Vytaltriple tripleeffect: effect: Meso

Rejuvenate––stimulates stimulatesnatural naturalcollagen collagenproduction production Rejuvenate ReduceWrinkles Wrinkles––Interrupts Interruptsand andslows slowswrinkle wrinkleformation formation Reduce Refresh––Vitamins Vitaminsand andminerals mineralsrevitalise revitaliseand andrein rein Refresh

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IN BUSINESS CUSTOMER SERVICE

Service with a smile

Antonia Mariconda on why good customer service and front of house staff are so essential to the success of your practice

What makes an aesthetic business great? Experienced professionals? skilled staff? state-of-the-art facilities? All of these factors undoubtedly play their part. There is another asset however, often overlooked, which is integral to the success of every business: its people.

A clinic may be run by skilled practitioners, but if its customer service is poor, clients are unlikely to return.

This is a truism that applies throughout the service industry. It doesn’t matter what the customer is seeking – a restaurant meal, a new dress or a tattoo – if they are treated brusquely or disdainfully, their perception of the company will be a negative one, all of us have experienced bad service at some stage in our consumer life, I assure you a bad experience is not easily forgotten.

In the aesthetics industry, a customer or patient will be visiting a clinic or business on account of the benefits to be derived from the procedure itself, be it laser skin resurfacing, laser hair removal, skin tightening or cosmetic injections, however, It’s the little things that will dictate whether the customer is likely to return and to recommend the clinic to their friends. Is the customer greeted courteously upon walking in? Is the aesthetic procedure explained clearly? do staff take time to allay any fears the client may have and to set them at ease?

What about post-operative care: does the practice manifest genuine care for the patient’s welfare? Are staff briefed to make a follow-up call in the ensuing days to check the patient’s progress?

A friendly smile and calming bedside manner alone will not make for an award-winning clinic. Nevertheless, any business that neglects these elementary aspects of customer care is bound to flounder. I’ve lost count of the amount of times a member of the public has outlined the failings of a clinic, and sometimes I kick myself when I hear a patient say “they just didn’t pay any attention to

detail, I don’t think I’ll be going back”.

As every successful business knows, it’s imperative to make people feel special. To make them feel important, To make them feel that their business matters to you, and that you view them as an individual – one with unique needs and emotions that must be catered for.

No one would return to a restaurant where the waiting staff insulted the customers – no matter how tender the steaks or how satisfying the cocktails. It’s the same in the aesthetics industry: what does the attitude of your staff say about you as a company? If the roles were to be reversed and you were to walk through the front door of your clinic as a patient, would you feel welcome?

Antonia Mariconda, The Cosmedic Coach is a beauty writer, author, and anti-ageing coach. Antonia has written four published books in beauty, surgery and health and is a popular blogger and Twitter beauty influencer.

She is currently a beauty presenter for Sky Fitness and Beauty TV. Follow Antonia @ CosmedicCoach on Twitter. www.thecosmediccoach.com

Most aesthetic professionals take great pride in their professional development, ensuring that they are trained in the latest aesthetic techniques and are accredited with relevant industry bodies. But what about – (to borrow a phrase from the catering industry)– the ‘front of house’ staff? Everyone, from the receptionist to the nurses, plays a crucial role in determining the patient’s impression of the clinic. Investing time in your human resources will not only aid employees’ personal development, but will help to create a working environment that is geared around the needs of the customer.

The following steps will enable you to evaluate your business and identify areas where more can be done.

Taking care of these ‘small details’ will help to complete the bigger picture – one in which your business is prized for its customer-focused approach. >> www.cosmeticnewsuk.com 39

IN BUSINESS CUSTOMER SERVICE

Based on extensive consumer feedback and interaction: The Cosmedic Coach guides you through The 10 Golden Rules that ensure your business has that winning ‘X’ Factor.

1. Be courteous and respectful. Just think of the golden rule: Treat others as you would like to be treated. Whether you’re a senior surgeon or a clerical assistant, every customer should be viewed as the most important person you will have to deal with that day. Nothing is disconcerting than a receptionist who’s more interested in playing with their phone or a nurse who would clearly rather be somewhere else.

2. Dress code: All employees, from clerical staff to cleaners, should look neat, professional and presentable. This means ensuring that uniforms are clean, hygienic and commensurate with the company image you wish to convey.

3. Local knowledge. This may seem an unusual tip, but it pays dividends to develop a good knowledge of the local area. Free car parking, the nearest pharmacy, shops, restaurants and the quickest way to get across town without hitting the rush hour traffic. Sure, we have smartphones and the internet to help with these things, but a little personal knowledge will go a long way towards earning customer trust.

YOUR OPINION Juney Jonigk, Patient, Location; Whiphaven

The front of line staff give the first impression of the business, and first impressions count.

Friendly, understanding and kind disposition is the order of the day!

Dr Dan Dhunna, Professional Location: West Midlands & London

Front of house staff is the first direct contact a patient has with your brand and can be make or break for many people.

4. Cool and Calm. At times, you’re going to have to diffuse stressful situations. On occasions, customers may become agitated and unreasonable. Even though it may go against all your instincts, it’s imperative that you don’t raise your voice or retaliate.

All those barbed responses on the tip of your tongue? Keep them in your head. That said, just because you are responding in a professional capacity doesn’t mean you should have to tolerate verbal abuse. If a situation is in danger of escalating, promptly seek support from a colleague.

Kelly Costello – Aesthetic Nurse Location, Kent

5. Be positive. Everyone has bad days; those occasions when personal problems

Mary Lissett, Patient, Cambridge

hang heavy or the traffic has gotten the morning off to the worst possible start.

Feigning happiness is not required; what is required is the ability to smile and be civil.

When you have a bad day, it’s human to want to vent and share it with someone. Just make sure that someone isn’t a customer.

6. Phone manners matter. Reception staff should answer the phone promptly and with a polite greeting. Moreover, callers shouldn’t be left on hold for any longer than a minute. Good phone etiquette is mostly about common sense. Make sure that all staff are briefed on the correct procedure for greeting customers. That way, you can be sure that customers will receive the same cordial greeting no matter who picks up the phone.

8. Keep busy. Nothing looks more unprofessional than the sight of abored receptionist texting friends or staring glumly out the window. During quiet spells, staff should use their time wisely, making the most of the opportunity to catch up on administrative tasks and other duties. This doesn’t mean employees should have their nose to the grindstone at all times: there may be occasions when it’s acceptable to make small talk with clients, for example, provided it’s not too intrusive.

9. A simple greeting goes a long way. The moment someone enters your practice, they should be cordially greeted. Doing so will instantly make the customer feel welcome and set them at ease. Courtesy costs nothing and boosts public perception of your business as effectively as any glowing patient testimonial.

10. Stay away from the tweeting, facebooking and social media, there is a time and a place for everything, nothing Is more off putting than speaking to a receptionist too engrossed in her Facebook update than to engage with your patient or client on an eye to eye level, ensure that any visible traces of social media are out of your clients eye sight, it’s just not professional to mix business and tweeting!.

40 www.cosmeticnewsuk.com

I’m front of house...as well as general dogs body! There’s nothing I wouldn’t do, that I ask of the girls, makes a huge difference.

A warm reception is really important! If you’re making a choice to go to a clinic or wherever you should always be received with a smile and even a hand-shake! I’ve never been to the above mentioned, but I’ve waited at hospital receptions and the staff have been so engrossed by the PC that you wonder if you’re invisible. What does it cost to give a patient a smile?

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IN BUSINESS BUSINESS FOCUS

HEAD IN THE CLOUD

Dr Natalie Blakely on cloud based patient management system

Dr Natalie Blakely is an award winning Cosmetic Doctor and the Medical Director of the Light Touch Clinic in Surrey. Dr Natalie is known for her expertise in administering injectable treatments.

Her less-is-more approach and down-to-earth personality have gained her a loyal clientele from across the UK and Europe and she is frequently invited by the media to comment on issues regarding cosmetic medicine. In addition to running her clinic, Dr Natalie has created Consentz, a patient management system for the iPad, with a host of unique features to streamline the consultation process, including voice-to- text transcription and instant image upload.

D

espite the cloud taking root in our mainstream culture there is still a lot of confusion surrounding it. When 1000 members of the public were interviewed in the US only 16% understood cloud computing, 51% said they believed stormy weather would interfere with it while 29% said they thought the cloud was a meteorological one!

There are hundreds of cloud storage providers on the web and their numbers increase every day.

You are probably familiar with several providers including Google Docs, email providers like Gmail, Hotmail and Yahoo! and social networking sites like Twitter and Facebook.

Explained simply a cloud based patient management system consists of a web-based interface through which patient data is input, processed and retrieved. The data is saved on a remote ‘host’ server, managed by a system provider and is accessible from anywhere with a 3G or wifi connection. There is no need to download software or store data on a hard-drive (unless you want to back it up manually).

Back up and security are handled by the system provider as are system maintenance and upgrades.

So if you are thinking about investing in a cloud-based system, here is my advice…

• Choose one designed by medical practitioners for medical practitioners, as well as a software development company When creating Consentz I used not just my own experience but that of other cosmetic doctors and nurses, to create a product that integrates the features that matter most to the busy practitioner.

The software company turned these features into functions resulting in a system that is both useful and user friendly.

• Choose an App that runs off an iPad or a tablet computer These devices are fast becoming the preferred PC choice for health care practitioners and their discreet, unobtrusive size have been shown to directly improve face to face contact with patients during consultations. In addition the intuitive touch screen enables the practitioner to enter data quickly in real time while staying focussed on the patient while a stylus enables digital signatures to be taken and securely saved.

Using a tablet also gives patients the impression that your clinic is modern and cutting edge… something you don’t get from crumpled manila file in a dusty old filing cabinet!

• Choose an App with a medical speech to text software built in I would highly recommend this if you spend hours typing up notes. In a nutshell speech to text software transcribes your patient notes into text as you speak.

It then stores them in the patient’s file on the server.

It’s essential the system has medical speech to text built in so that it recognises and accurately transcribes key words used within the industry.

• Choose an App with instant image capture and upload For most practitioners taking, uploading and filing patient photos is one of the most time consuming

www.cosmeticnewsuk.com 43

IN BUSINESS BUSINESS FOCUS

Your patient database is the beating heart of your business so it is essential that all your contacts can be imported easily elements of the job. It’s something that should happen during the appointment, but invariably doesn’t leaving the practitioner with a batch of photos to upload, document and file when the clinic has shut. So to set yourself free from this labour intensive task choose a system that enables you to take high resolution before and after photos with your iPad or tablet during the consultation and then saves them to the patient’s file in instantly. As well as ruling out the need to upload and file photos from a separate device, it gives practitioner and patient the opportunity discuss and review treatment in a visible context, so the patient is fully engaged in the treatment process from start to finish.

• Choose an App that offers a visible record of treatment This function enables you to mark on the patient’s photo the selected treatment, the location of treatment, the quantity of product used, the lot number and the date of treatment (Consentz does this with unique colour coding tool).

These records are then linked to the practitioner and the clinic enabling better aftercare and full accountability should post-procedure complications arise.

• Choose an App with a trace and trace function The Keogh Report has recommended a registry should be established for breast implants and other devices. This should alert the authorities to any signs of concerns at an early stage and will provide critical intelligence in the event of a product failure or recall. So by choosing an App with a track and trace function you can rest assured that in the event of a product recall such as PIP, you can locate patients immediately by simply typing in the lot number of the product.

• Choose an App with digital questionnaires and consent forms that can be completed by the patient in situ on the iPad or tablet screen One of the most time-consuming elements of the admin process is the filling out of health questionnaires and consent forms by the patient.

This is usually done pre-appointment but if the patient is late it can impact on the appointment itself. And I’m sure I’m not the only one to admit this vital paperwork sometimes gets filed in the wrong

44 www.cosmeticnewsuk.com

place or even lost! Obtaining proper, informed patient consent was one of the key recommendations of the Keogh Review. Providers are obliged to ensure that people are aware of the implications and risks of a procedure before agreeing to treatment. The portable and intuitive nature of tablet PCs means questionnaires and forms can be filled in effortlessly at the touch of a button and signatures signed with a digital stylus. The information is then saved to the patient’s file in the cloud and accessible at a moment’s notice.

• Choose a system that’s integrates with your current CRM Your patient database is the beating heart of your business so it is essential that all your contacts can be imported easily. You may also want to check that you can save patient records manually in a CSV file should you wish to have a local back-up too.

• Choose a system that runs off an iPad or tablet PC This will enable you to access your database and input patient details remotely, wherever there is a Wifi or 3G connection. This is essential for the mobile practitioner but also for the doctor or nurse who works from several clinics and can done by tethering you iPhone to your iPad, if your iPad doesn’t have built in Wifi.

• Choose an App that is hosted by a trusted server over SSL with an SSL certificate The rapid emergence of cloud computing is part of a fundamental shift in how IT services are developed and delivered. The upsides of cloud computing include fast set-up and enabling businesses to be more flexible and innovative as well as lowering costs and increasing turnover. But cloud computing is not without risk. Questions regarding security, data ownership and reliability of the cloud are the top concerns for most businesses.

When a clinic embraces a cloud-based patient management system it is in essence entrusting its patient records to a third party. Cloud providers must therefore offer complete transparency when it comes to their underlying infrastructure, support and maintenance procedures. So to start with choose an App that is hosted by a trusted server such as

Google, using SSL. SSL - an acronym for Secure Socket Layer - creates an encrypted connection between your App and the server allowing for private information to be transmitted without the problems of eavesdropping, data tampering or message forgery. It also prevents passwords being intercepted when typed into a secure login page.

In order to verify their SSL your server should have an SSL certificate. This is usually indicated by a padlock icon in the web browser or a green address bar. As long as the server has an SSL certificate you can be sure that the information you enter is secure and only seen by you.

The other big concern with the cloud storage is reliability. All cloud storage systems store the same data on several different servers. This is called redundancy and basically means that you can still access your patient records at any given time even if Here are a few questions to ask before you sign on the dotted line...

• How secure is your data? Does the server have an SSL certificate? What happens in the unlikely event the server is hacked or crashes?

• What happens if your patient management system provider goes bust? Will your data be sent back to you?

• Likewise what happens if you want to change patient management systems? Will your data be returned to you in a format you can then import into another system?

• Where are the system’s servers located?

The European Union’s Data Protection Directive prohibits the storing of data outside the EU, so this is something worth checking with the system provider.

Check the App is easy to set up and use, not just for yourself but your colleagues too It should synchronise with your calendar and CRM and enable you to upload a list of treatments consent forms specific to your business. All these preliminary stages should be mapped out visually with clear, easy to follow instructions. In addition the system provider should provide experts both online and at the end of a phone to guide you through the process. There’s no doubt in my mind that cloud based patient management systems will become the norm within our industry in the next five years. I have seen with Consentz how the right system can streamline the admin process, remove time-consuming paperwork, increase turnover and help practitioners deliver a better service to their patients, as well as freeing up valuable floor space.

info@uniqueskin.co.uk 0208 950 9501

IN BUSINESS CLIENT RETENTION

RetentionSpan Zoe Davitt from Blue Horizons on the importance of client retention

Zoe Davitt BA (Hons) DipCAM (MComms) is Managing Director at Blue Horizons Marketing and has been working within the dental and facial aesthetic sector for over ten years. A regular contributor to dental and aesthetic trade publications, she has a Diploma in Marketing Communications and is an active member of the Chartered Institute of Marketing (CIM).

All businesses need a healthy stream of new life blood but don’t fall into the trap of focusing all of your efforts on acquiring new clients.

As a consumer myself, I get frustrated on countless occasions when businesses neglect me, the loyal customer, in favour of offering incentives, offers and promotions to new prospects only – a certain satellite broadcaster are notorious for this!

As a marketer, I get equally frustrated when clients assume that increased sales are only a result of ‘selling’ to new clients. What about your existing client base? It makes far more sense to upsell to your existing clients and get them to recommend/ refer their friends/family/colleagues on to you.

Chances are, such referred clients will become better, more loyal clients than a new one who has been tempted into your clinic with a promotional

offer (and is therefore statistically more likely to hop to the next clinic for the next offer).

There is also a great economic reason for focussing on your existing clients first. The cost of keeping an existing customer can be as low as one fifth of the cost of finding a new one. So the rule should always be to farm existing customers by identifying more of their needs, than fishing for new customers, whose needs you don’t know.

Of course all businesses experience churn and as such you will always need an influx of new clients to ensure business thrives. But the lifetime value of a client is what you should be considering.

Good, quality clients who attend regularly and who recommend you to their friends and family.

In order to achieve this you must regularly communicate with your clients. Loyalty needs to be earned and you cannot expect your clients to trust you if they don’t hear from you in between visits.

A recent piece of research in the USA asked why customers stopped buying from companies. Was it price or quality? Had they changed location? 68% respondents ticked no specific reason. So they did further research amongst this group to try and find a reason and the main response was ‘because they didn’t keep in touch’.

So regular contact with your customer base is critical!

Retention: What it’s all about 46 www.cosmeticnewsuk.com

The humble newsletter: an excellent client retention tool Marketing isn’t just about advertising. It’s about communicating with your clients to ensure that their needs and wants are anticipated and met in a way that satisfies your customer and is profitable for you.

The ideal scenario that you should be working towards is to build and maintain strong, lasting relationships with your client base. This doesn’t happen instantaneously overnight. As with all relationships, it takes time, effort and regular contact.

Introducing a newsletter (paper based or digital) is an excellent communication tool for any aesthetic clinic.

Benefits include: • Encouraging client loyalty and making them feel valued • Promoting new and existing treatments/services • Provide offers/discounts • Educating clients about aesthetic matters • Reactivating dormant clients • Encouraging referrals from existing clients • Attracting new clients It is dangerous to assume that your long-standing clients know the full array of the treatments that you offer; you must gently but constantly remind them.

Imagine what a difference it would make to your bottom line if a mere 10% of your dormant clients called up to book an appointment?

Recommendations & word of mouth

The power of testimonials

The cheapest and easiest way to market your clinic is via word of mouth referrals. The hard bit is ensuring that every element of your service is top notch to warrant your clients not only coming back but spreading the word about how you great you are.

One of the most powerful ways to get your marketing message across is to use testimonials. Real clients providing real testimonials do your marketing for you. People will connect much better with a client saying how great you are rather than you providing a great sales pitch about yourself!

If you don’t ask, you don’t get. It is the client’s choice as to whether they want to keep you a secret. You need to proactively ask your clients to refer you; there is often a misconception that you aren’t taking on any new clients or that you don’t want to, so you need to actively promote the fact that you are always happy to accept new clients - especially those who are referred by existing clients.

Why not have simple referral cards printed for your clients to hand to their friends and family, which are given to them at the end of their appointment?

If you wish you could also offer an incentive to both the new client and the existing client.

Remember though that you must always seek permission before using them.

Never falsify testimonials; if you need to do this there are fundamental issues with your service provision that need addressing before you market yourself.

“Thank You” goes a long way Remember to thank your clients for any referrals you receive. clients are human beings and crave praise, reward and to feel valued – don’t take them for granted.

• • •

Greeting cards – Birthdays &/or Christmas. Make clients feel valued and cared for and ensure your clinic remains at the forefront of their mind when they think all things aesthetic Personal note from clinician - at the end of a more extensive course of treatment, send a personalised note to the client. The level of after-care leaves a lasting, positive impression Small gifts - if a client provides you with a glowing video testimonial or refers a friend to you, say ‘thank you’ with a token of your appreciation – a simple bouquet of flowers or box of chocolates always go down well but perhaps try something more memorable – a lottery ticket, a meal out, jewellery and so forth.

Offer value

The bottom line

Since the downturn in the economy, regardless of disposable income, everyone has become more value conscious. Rather than always thinking in terms of slashing prices, think in terms of how you can add more value to your offering.

• Combination packages – for example, 10% off the total cost when clients request a combination of antiwrinkle injections & dermal fillers or offer a goodie bag containing relevant products • Membership schemes – clients like the security of knowing their aesthetic needs are taken care of plus the added benefit of discounts on additional treatment. For you, it means a steady income stream • Finance options – provide clients with the option of spreading the cost of higher cost treatments. This could be the only stumbling block in their purchase decision.

80% of your revenue will come from 20% of your clients

The ultimate aim is loyalty Loyal clients attend frequently, spend frequently and bring you even more clients. In order to build loyalty, your clients must trust you.

Trust n. 1. Firm reliance on the integrity, ability, or character of a person or thing.

Do what you say you’re going to do and act professionally at all times. If your receptionist says she’ll pop a brochure in the post today, make sure she does. Be honest, be predictable. Give the right advice and know what you are talking about; a client must believe that you have their best interests at heart.

Do your homework. Get to know your numbers – ratio of active to dormant client numbers, average revenue per client, average frequency of attendance, how much you spend on advertising, number of enquiries through your website and so forth until you build a clear picture of who/what the most profitable clients/treatments are and where they come from.

You need to ensure that your marketing focuses on the retention as well as the acquisition of clients. By offering excellent service, communicating regular with clients and encouraging and rewarding referrals you will find that your appointment book is looking healthy and you can focus on what you do best.

You build loyalty by: • Treating your team well so that they in turn treat your clients well • Showing your clients that you care and remembering what they like and don’t like (simple notes on a client’s file, both clinical and personal, act as a conversational prompt and really make the client feel valued) • Keeping in touch with your clients in between visits via newsletters, emails, cards and such like In short, you build client loyalty by treating people how they want to be treated. www.cosmeticnewsuk.com 47

10-11TH MAY 2014 LONDON OLYMPIA www.anti-ageingshow.com

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2014 Highlights: • Celebrity speakers share their beauty secrets • Live demonstrations from leading beauticians & cosmetic doctors • Innovative dental & eye treatments • Personalised skin analysis from the Visia Skin Age Booth • Sample new products & learn about exciting product launches Speakers will include leading reconstructive surgeon Rozina Ali, Cosmetic Guru Dr Rita Rakus, hairdresser to the stars Nicky Clarke and Dr Daniel Sister who will demonstrate his infamous, ‘Dracula Therapy’ live at the show.

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IN BUSINESS BEST PRACTICE

EXPERIENCE COUNTS

Richard Crawford-Small on Consumer Services vs Customer Experiences

H

as austerity changed the game? The economic headwinds have touched us all, and it’s been a very challenging few years to say the least. Yet now, as things begin to brighten after the storm and the consumer indices begin to show positivity, will there be the cultural legacy from this period of austerity? You betcha! The British will finally refuse to accept poor quality and poor service.

My big takeaway from the last four years, is how intolerant I have become of mediocrity. The fact that I have to work hard for my money, means that I am loathe to just hand it over to some one who thinks that charging Four Quid for a cup of lukewarm coffee is acceptable. Starbucks, we pay our taxes, you pay yours.

Maybe its because i’m getting older and more grumpy, but I look around and I do see a pattern emerging, and major business worldwide are focussing heavily on “customer experiences”. The cynic in me is saying that plain ol’ Customer Services simply isn’t cutting the mustard, so lets change the job title from “Customer Services Rep”, to vs “Customer Experience Advisor” and carry on as normal with the same level of service.

As recent personal experiences would suggest, some companies view this as a valid strategy, however later I provide some examples of this being executed well. So, In your business, is it still “Front of House Team” or is it “Your Customer Experience Team”. Well, funky job titles aside I do think that if executed with excellence, a focus on customer experience is the right thing to do.

Working with start up businesses, we focus on business models and creating a powerful customer experience, as well as generating profit. Why? Because a true start up business, creating a unique product will have a small number of customers so its easier to manage them, and an influential evangelistic early adopter is worth its weight

in gold. However, once the business becomes established, it becomes easy to forget about the customer experience and focus purely on the numbers; you forget the thing that made you successful in the first place.

I advise clients to not only look at the finances, but also use customer satisfaction as measures of business success, as recessions tend to clean out poorly performing companies. Your business may look strong on paper, but if your not looking after your customer, eventually they will punish you.

So think about your staff; What are their roles? Is your business focussed to welcome, to smile, to engage or does it appear austere and unfriendly?

Below are some examples of what you can do to get your self and your team focussed on the goal of creating compelling customer experiences

1. Don’t use The Goldfish Principle I recently read an article on LinkedIN by a Management Consultant called Don Peppers, who has coined the phrase “The GoldFish Principle” to describe business memory.

Some species of tropical fish have no territorial memory, and are therefore more than happy to circle a bowl as there is always something very interesting to see, think Dory in Finding Nemo. (Just keep swimming.....)

Customers are not tropical fish, and calling someone three times to say “we’re just calling to see if you’re interested in our latest promotion”, is Goldfish Principle in action. When said customer comes in to claim the latest promotion, having no idea what they’re talking about, is also Goldfish Principle and an example of poor execution of a marketing plan.

Try to operate on the principle that whoever you are

www.cosmeticnewsuk.com 49

IN BUSINESS BEST PRACTICE

talking to deserves your FULL attention, if they’re a customer, they’re your best one. If they’re not, they soon will be. With the technology available to you to provide customer continuity, operating on the GoldFish Principle is worse than not doing anything at all, it will actively destroy trust in your brand and also is such an easy thing to discuss on Twitter, as shown later. All you really need to do is understand their individual needs, and remember it - this is why treatment plans are so powerful, as they not only provide continuity of care, but also continuity of brand.

As Don says “Operating on The Goldfish Principle today doesn’t just communicate that you aren’t competent enough to run a sound business, it actually broadcasts that you don’t care enough about customers even to try to be competent.

Don’t do it”.

2. Have Humanity

passenger, spent $1,000 on turning a complaint into a Twitter Advert that went viral, slamming BA for losing his luggage.

It trended because it was new and quite funny, and news stories referencing this in articles were also shared, generating more coverage. Mashable attracted 10,000 shares of it’s article, so think about what kind of online experience do you want your customers to have?

base. However, I will use three personal examples to illustrate this point.

Taking my cue from Hassan Syed, I tweeted Vodafone Customer Services after waiting for 20 mins on hold before being accidently cut off; Now how did I feel? As you would, ignored, annoyed, treated with offhand contempt. I did email and two days later recieved a reply, and as of time of writing it has been sorted, but the damage has been done - I no longer trust Vodafone as the right fit for my business.

The goal of speaking to your customers is clearly to get them into the clinic for a consultation, and great examples of “Offline Customer Experiences” (please forgive me, I have just created marketing jargon), is the Personal Stylist Programme at Nordstrom, a US department store.

In Marketing 101, there is talk of the 3p’s; Is this the Goldfish Principle? Yes, Is this supporting a customer online? Sort of Is this being easy to deal with? No

We need to add the 3H’s

My Mum LOVES shopping, and I was in a Nordstrom Houston with her for what seemed like three days, (Thanks for that Mum), while she had a personal stylist appointment. The Nordstrom Programme is a combination of stylist, fashion buyer, sales, and counselling. Its a free service and the stylist/ counsellor gets commission on the sales, but what struck me about it was that it wasn’t a huge sell, in fact, that day my Mother didn’t buy much, but that the strength of the relationship between them was incredible! They were like friends, and my mother now judges every shop by this standard, and expects warmth, empathy and time from all of her interactions with servers.

Humans online - How do we support our customers online and through Social Media?

Humans offline - How do we support our customers when we speak to them?

Humans in your business - How do we support our employees and partners?

Go to a Nordstrom, and check it out.

If you can’t make it the the US, another example is the Apple Genius Bar. Yes, I know I love Apple, but PC World have tried to ape it with the Geek Squad and It’s not quite worked. Why? Because you might think I’m a geek, but I think I’m cool.

Ikea on the other hand - if there is a piece missing from a pack, try getting a replacement sent to you, as there is no policy at all on missing components, but definitely a policy of self righteousness.

Notice here the key word I use is support, not sell, give and you shall recieve. There is an increasing trend of people using Twitter to call out poor service, and you cannot ignore the human element. Hassan Syed, disgruntled British Airways

3. Be easy to deal with

So, is customer experience the way forward, or is it just a new way of packaging quality customer service?

The final thought is a simple one - just be easy to talk to. This is very easily said but in practice quite a challenge, especially if you have a large customer

Let me know, just leave a message on my voicemail.

I bet your humming “just keep swimming” all day.

Product - What is our product or service?

Price - What is its cost/value proposition?

Promotion - How are you going to sell it?

All good stuff, but the 3P’s weren’t enough so there are now Seven P’s, (I’m not going to detail them, if your interested Google the Seven P’s of the Marketing Mix) Following this will really help you to get the elements of you business in order, but it doesn’t really capture this exciting Post PC era that we are now in.

Another example is Lego. The Danish toy company is now only behind Mattel as the worlds biggest toy manufacturer. Every now and again they get it wrong and there is a missing or deformed brick in the latest expensive Star Wars Lego kit your being forced to build. Getting a replacement is easy, there’s a no questions asked policy on missing bits, and before you say it, clearly a no questions asked returns policy on a medical treatment is not workable, but you get my point.

References: 1. Don Peppers - Founding Partner, Peppers & Rogers Group Measuring the ROI of a Good Customer Experience 2. Man spends more than $1000 to call out British Airways on Twitter. Business Week 03 Sept 13 http:// business.time.com/2013/09/03/man-spends-more-than-1000-to-call-out-british-airways-on-twitter/ 3. Nordstrom Personal Stylist - https://secure.nordstrom.com/services/personal_touch.asp?attempt=1 4. Lego becomes worlds second biggest toy maker. BBC News 05 Sept 13. http://www.bbc.co.uk/news/ business-23968860

50 www.cosmeticnewsuk.com

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IN BUSINESS TOP TIPS

The big 5 Richard Crawford-Small gives us his top 5 tips for business success Embrace Technology Your customers are far more tech savvy than you give them credit for; This is the Papal Inauguration of Pope Benedict in 2005 & Pope Francis in 2013. The differences are clear for all to see. The Smartphone has revolutionised the way we interact with the outside world. But even in 2005 the latent demand is there if you look closely you’ll spot the early adopters; one taking a photo with a mobile phone and another texting. Stick an MP3 player in a phone and connect it to the internet and boom. Move your business practices from 2005 to 2013 and ditch paper.

Focus on what you can control The economy, footfall, bad news stories in the press, your competitiors latest marketing campaign. Forget them, drive them out of your mind and focus on what you can make an impact on; delighting your next patient; follow up, your customer journey. It’s your business, don’t waste time worrying about everyone else.

It’s all about the customer It’s very, very easy to get wrapped up in your own business and allow all of your processes and energy to become focussed solely on you. “If I charge more here, I’ll make more profit’, If I cut back on this then I’ll be able to get that new car”. In the short term these strategies are effective, but will reduce your growth in the medium to long term, as your customer WILL notice that you are only thinking of your bottom line. Customer Satisfaction is the number one measure of a businesses success. Instead, focus your energy on Investing in your business; and improving your customer journey; “What can I do differently TODAY to improve my offering?

What can I do TODAY to make a difference to my customers?”

Set Goals Goal setting focusses the subconscious mind on the task in hand and enables us to apply our considerable resourcefulness to achieving it. If you don’t have a preferred method, I can recommend this approach to the task; “A committed decision to reach a predetermined specific goal, combined with a burning desire, followed by immediate, massive action repeated consistently for as long as it takes until your goal is reached“.

What is the difference between success and failure?

•Make your committed decision, these things are worth the sacrifice.

•Now write down 10 SPECIFIC GOALS and let your mind soar, in this life we are constrained only by ourselves so really go for it.

•Rank your goals 1-10 in order of importance to you.

•You must have a Burning Desire to your new goal; it MUST be worth the effort, this MUST become a magnificent obsession and if your enthusiasm to achieve it needs to be mustered then review its importance.

•Repeat consistently. Apparently it takes 30 days for habit forming activities to embed themselves and probably five minutes to break them, and often we take on too much in one go. Change your life and habits one at a time, and train yourself to succeed and achieve your goals.

•For as long as it takes - never give up!

So take your time, focus on what you want to achieve, be sure you want it and enjoy the ride.

Be consistent with your efforts and don’t overdo the “me” It is very easy to unwittingly alienate people on Twitter.

Just think of yourself hiring a nice consultant, me perhaps. We link up on Twitter and I bombard you with tweets of me enjoying a debonair lifestyle and not working. Suddenly, you will become keenly focused on the fee and not the quality of my work. Your patients would react in the same way. A nice way of thinking about it is the concept of a Cocktail Party; if you meet Mr or Mrs BIG I AM, how do you react? If you feel uncomfortable talking about it in an intimate gathering, don’t tweet it. Social Media is the MEDIUM, Facebook and Twitter are the TOOLS, the mechanism for you to use to ENGAGE with your patients. It is still a patient at the end of the day, and you still need to have an objective and a plan to acquire them.

However, before you start think about how much time you have to dedicate to this. You need to be disciplined and commit at least 2-5 hours per week to be consistent with your efforts and not be a flash in the pan. Also, and quite boringly if you are employed or are a contractor check that organisations policy on the use of Social Networking. Some are quite restrictive, and it would be a shame to

52 www.cosmeticnewsuk.com

have to shut down after a few days.

Alizonne -WINNERS 2012-2013

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Judith Lost 5st

Judith before treatment

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Alizonne Therapy is a revolutionary medically supervised treatment program... that combines weight loss with body contouring. Designed by our medical doctors, Alizonne Therapy can dramatically improve appearance and long term health. The treatment comprises of four essential elements - ultrasound therapy, connective tissue therapy, medical diet and stabilisation.

Alizonne was first launched in the UK by Dr Mark Palmer from his Leeds clinic in 2006 and now consists of two wholly owned successful clinics, one joint venture clinic and a total of 16 independent partner clinics with 6 further clinics coming on board in 2013, all licensed by Alizonne UK and managed to our specific uniform standards and protocols.

before treatment 2010

treatment 2011

treatment 2012

treatment 2013

1

3 years after completing Alizonne Therapy

3

2

Judith looks better than ever!

4

5

7 9 10

6 8

11

The introduction of Alizonne Therapy at Health and Aesthetics has given the clinic a great boost. This treatment is simple to administer. Patients have found it very effective and have achieved amazing results. I only wish I had introduced Alizonne Therapy much sooner at Health and Aesthetics

We’d already identified the growing problem of obesity and spent 2 years looking for a credible medical solution for our patients. Alizonne Therapy ticked all our decision boxes and made a significant impact on our business from day one.

We’re delighted & just wish we’d started sooner!

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Business Director. Dermal clinic Clinic location: Edinburgh

If you would like to be a part of the Alizonne success story...

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THE AESTHETICS CONFERENCE AND EXHIBITION 2014

TWO EVENTS IN ONE NEW NAME Why you should be visiting the Aesthetics Conference and Exhibition 2014

In a growth industry where innovation in technology, products and techniques is engaging clients and driving them through the doors of your practice, keeping abreast of what is new in the market is essential to running a successful business.

Attending an industry meeting where all the leading suppliers are present, under one roof, is one of the best ways to make sure you are up to date with what is going on in the industry and, more importantly, to find out how these new trends and technologies can benefit your practice and, ultimately, your patients. Now in its fifth year, The Aesthetics Conference and Exhibition, formerly the Cosmetic News Expo and Aesthetics Conference, is the first key meeting in the UK industry calendar. Taking place at the Business Design Centre in London on March 8-9, 2014, The Aesthetics Conference and Exhibition is estimated to be the UK’s largest event for medical aesthetic professionals, with over 800 expected to attend.

• • • •

Both the conference and the exhibition provide you and your practice team with everything you need to keep up to date with the industry.

Combining academia with business and networking opportunities through approved professional development lectures, workshops and masterclasses as well as business seminars and customer service workshops, the whole team will find something of benefit. Here we tell you more about why visiting both events can benefit you and your practice…

As a delegate you will have access to masterclasses and seminars given by some of the aesthetic industry’s leading clinicians. You will also have free access to the UK’s largest exhibition of premium manufacturers and distributors, showcasing their latest products and services.

Interactive workshops will take place in the exhibition hall and will include technique training, live demonstrations and business skills sessions.

The Exhibition The Aesthetics Exhibition is the UK’s largest exhibition of premium aesthetic manufacturers and distributors. Open to all industry professionals, the exhibition is free to attend, so why not bring the whole clinic team along to network with fellow professionals, take advantage of the free business and customer service workshops and find out about the best products and services currently on the market.

• Catch up with all your suppliers under one roof and take advantage of exclusive show offers

Attend free exhibitor workshops Network with your peers Hear about new launches Build your clinic’s offerings

The Conference Continued professional growth and updating of skills is key to the development of any specialty, especially in one so dynamic and ever changing as aesthetic medicine. In addition to sharing best practice and networking with peers, the Aesthetics Conference offers delegates a chance to gain value for money CPD accredited education through its premium scientific programme.

Dr Eithne Brenner

With up to 24 CPD points on offer over two days, The Aesthetics Conference offers excellent value for money. One day admission to the conference, including lunch and refreshments is just £89 while admission to both days costs £160.

If you book before November 30 you can take advantage of our early booking offer and receive a 10% discount. Just use the promotional code HXA38 when booking. You can book online at www. cosmeticnewsuk.com or by calling our customer support team on 01268 754 897.

CONFERENCE HIGHLIGHTS Key topics and speakers confirmed so far include:

• WHAT IS NEW WITH FILLERS AND OTHER INJECTABLES? - DR SABINE ZENKER • FACIAL ANATOMY REVIEW WITH REFERENCE BOTULINUM TOXIN INJECTIONS - PROF VISHY MAHADEVAN • OVERVIEW OF COSMECEUTICAL INGREDIENTS AND WHAT THEY DO - DR TAMARA GRIFFITHS • COMPLICATIONS OF NON-SURGICAL PROCEDURES AND HOW TO MANAGE THEM MR DALVI HUMZAH • RADIO- FREQUENCY, ULTRASOUND OR LASER, WHICH RESULTS GIVE THE BEST RESULT? MR MARTIN COADY

NEW FOR 2014: EVENING DEBATE The Aesthetics Conference will also host an evening debate with a drinks and canapé reception. Delegates will be able to network with peers before interacting with a panel of experts to debate the latest topics currently affecting the industry.

54 www.cosmeticnewsuk.com

“The Aesthetics Conference 2013 was an informative and well organised conference. The lectures and live demonstrations were fantastic.”

Book The Aesthetics Conference and Exhibition now by calling 01268 754897 or visit www.cosmeticnewsuk.com to book online.

Join us for the UK’s Largest Aesthetic Meeting

TH TH 8THE -9 MARCH 2014 BUSINESS DESIGN CENTRE, LONDON SPONSORED BY

Continued professional growth and updating of skills is key to the development of any specialty, especially in one so dynamic and ever changing as aesthetic medicine.

The Aesthetics Conference offers delegates a premium scientific programme with masterclasses and seminars given by some of the leading lights in aesthetics. Here are a few reasons why you should book your place today…

• FREE EXHIBITION ENTRY • Gain CPD accredited education at exceptional value • Take part in workshops and live demonstrations • Learn from some of the industry’s leading figures

CALL 01268 754 897 OR VISIT WWW.COSMETICNEWSUK.COM

DATES FOR THE DIARY

D AT E S F O R T H E D I A R Y WE ROUND UP UPCOMING EVENTS, TRAINING COURSES AND MEETINGS

October 4-5, 2013 British Association of Aesthetic Nurses (BACN) Annual Conference, Manchester, www.cosmeticnurses.org

October

1-3 Advanced Skin Laser Applications (Inc. Core of Knowledge), The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 5 Microsclerotherapy, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical. com/events 5 Botulinum Toxin in Facial Aesthetics: new users - includes all major brands, Edinburgh, www.innomedtraining.co.uk 6 Dermal Fillers in Facial Aesthetics: new users to hyaluronic acid fillers, Edinburgh, www.innomedtraining.co.uk 7 Platelet Rich Plasma (PRP), Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 8 ZO Medical, Kingsmead Medical Centre, Regency Way, Kingsmead, Cheshire, training@wigmoremedical.com 9 Business Development, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 11 ZO Medical, Wigmore Medical 21 Wigmore Street, London, training@wigmoremedical.com 12 Chemical Peel Systems & Medical Skincare: comprehensive course for new users, Central London, www.innomedtraining.co.uk 12 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 12 Aesthetox Tear Trough Course, Birmingham, www.aesthetox.co.uk 13 Mesotherapy for localised fat, cellulite & skin rejuvenation: new users, Central London, www.innomedtraining.co.uk 14 Medik8 Dermal Roller, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 15 Skincare & Chemical Peels, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 15 CIBTAC ENDORSED Cosmetic thermotherapy and Cryotherapy, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 16 Intro to Toxins, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 16 Advanced Non-Surgical Facelift, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 17 Intro to Dermal Fillers, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events/ 17 CIBTAC ENDORSED Ultrasound for skin rejuvenation and wrinkle reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 18 Advanced Toxins & Fillers, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 18 Pressotherapy for lymphatic drainage and cellulite reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 19 BioSlimming, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 21 Clinical Training Update, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 28 Hair Removal Masterclass, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 21-22 CIBTAC ENDORSED Ultrasonic Lipo-Cavitation, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 23 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 24 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 25 Sculptra Refresher, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 25 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 26 Aesthetox Foundation Botox and Dermal Fillers, London, www.aesthetox.co.uk 26 CIBTAC ENDORSED Cryotherapy Induced Lipolysis, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 28 GloMinerals, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 56 www.cosmeticnewsuk.com

Dermaceutic Peels Training in Warrington, Monday 28th October email clive@cliveswan.com or call Clive Swan on 01923 266339

November

1 CPR & Anaphylaxis Update, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 4-5 Manchester-Module1: Product Knowledge (10am - 4pm) www.skingeeks.co.uk/training 6 Manchester-Module2: Chemical Peeling (9.30am - 4.30pm) www.skingeeks.co.uk/training 6 Platelet Rich Plasma (PRP), Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 6 ZO Medical, Medizen Clinic, 282 Lichfield Road, Mere Green, Birmingham training@wigmoremedical.com 9 Aesthetox Foundation Botox and Dermal Fillers, Birmingham, www.aesthetox.co.uk 9 Botulinum Toxin in Facial Aesthetics: new users - includes all major brands, Greater Manchester, www.innomedtraining.co.uk 10 Dermal Fillers in Facial Aesthetics: new users to hyaluronic acid fillers, Greater Manchester, www.innomedtraining.co.uk 11 Tattoo Removal Masterclass, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 11 CIBTAC ENDORSED Cryotherapy Induced Lipolysis, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 11 Medik8 Dermal Roller, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 12 Manchester - Module3: Advanced Chemical Peeling (10.30am - 3.30pm) www.skingeeks.co.uk/training 12 Skincare & Chemical Peels, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 12 ZO Medical, Kingsmead Medical Centre, Regency Way, Kingsmead, Cheshire, training@wigmoremedical.com 12-13 CIBTAC ENDORSED Ultrasonic Lipo-Cavitation, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 13 Core of Knowledge, The Lynton Clinic, South Manchester, 01477 536975, info@lynton.co.uk 13 Intro to Toxins, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 14 CIBTAC ENDORSED Ultrasound for skin rejuvenation and wrinkle reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 14 Intro to Dermal Fillers, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 15 Refresher Toxins & Fillers, Wigmore Medical, 21 Wigmore Street, London, www. wigmoremedical.com/events 15 Advanced Non-Surgical Facelift, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 18 Pressotherapy for lymphatic drainage and cellulite reduction, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com Dermaceutic Peels Training in London, Monday 18th November email clive@cliveswan.com or call Clive Swan on 01923 266339 18-19 Surrey KT24 6DU -Module1: Product Knowledge (10am - 4pm) www.skingeeks.co.uk/training 20 Surrey KT24 6DU-Module2: Chemical Peeling Practical (9.30am - 4.30pm) www.skingeeks.co.uk/training 19 Advanced facial treatment (Combined Course), Ely, Cambridgeshire, 01353 77 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 20 Infrared for weight loss and detoxification, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 21 BioSlimming, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 22 CIBTAC ENDORSED Diamond Microdermabrasion for Face and Body, Ely, Cambridgeshire, 01353 777 303/0774 769 6815, Barbara@academyofadvancedbeauty.com, www.academyofadvancedbeauty.com 23 Aesthetox Foundation Botox and Dermal Fillers, Manchester, www.aesthetox.co.uk 24 Aesthetox Masterclass Botox and Dermal Fillers, London, www.aesthetox.co.uk 25 GloTherapeutics, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events 25 Oxford OX4 4GP-Module3: Advanced Chemical Peeling (10.30am - 3.30pm) www.skingeeks.co.uk/training 26 Oxford OX4 4GPâ&#x20AC;&#x201C;Module4: Acne, Rosacea and Pigmentation (10.30am-3.30pm) www.skingeeks.co.uk/training 26 Advanced GloTherapeutics, Wigmore Medical, 21 Wigmore Street, London, www.wigmoremedical.com/events/

BEST UK AESTHETIC TRAINING PROVIDER as voted by our customers!   

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Training in Small Groups to give you a more personal learning experience.

Medically-led independent full-day courses run by professional trainers.

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Hands-on training on live course models - giving you lots of hands-on practice.

FREE after-course help and support as you build your confidence.

Post-course reference information Includes; copies of presentations, leaflets, literature, medical history & consent forms and treatment forms to take away.

Practical advice marketing, insurance, pricing, client care, websites, ordering.

Certification courses recognised by major insurers (e.g. Hamilton Fraser).

Easy-to-get-to locations centres in London, Southampton, Birmingham, Newcastle, Greater Manchester & Edinburgh

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Forthcoming hands-on course dates...

2013

DATE

HANDS-ON COURSE

Sat 5th

BOTULINUM TOxIN IN FACIAL AESTHETICS: new users - includes all major brands.

Edinburgh

Sun 6th

DERMAL FILLERS IN FACIAL AESTHETICS: new users to hyaluronic acid fillers.

Edinburgh

Sat 12th

CHEMICAL PEEL SySTEMS AND MEDICAL SkINCARE: comprehensive course for new users

Central London

Sun 13th

MESOTHERAPy FOR LOCALISED FAT, CELLULITE AND SkIN REjUvENATION: new users

Central London

Sat 2nd

ADvANCED BOTULINUM TOxIN: experienced users

Central London

Sun 3rd

ADvANCED DERMAL FILLERS: experienced users

Central London

Sat 9th

BOTULINUM TOxIN IN FACIAL AESTHETICS: new users - includes all major brands

Greater Manchester

Sun 10th

DERMAL FILLERS IN FACIAL AESTHETICS: new users to hyaluronic acid fillers

Greater Manchester

Sat 30th

BOTULINUM TOxIN IN FACIAL AESTHETICS: new users - includes all major brands

Central London

Sun 1st

DERMAL FILLERS IN FACIAL AESTHETICS: new users to hyaluronic acid fillers

Central London

Oct

Nov

Dec

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LOCATION

01928 739 712 corporate AND MEDICAL

finance

www.cmf-ltd.co.uk

ADVANCED SKIN SCIENCE TRAINING COURSE NOVEMBER 11TH MANCHESTER

on products after most courses

A personalised one-to-one mentoring service also available.

Call to book or more information 023 80 67 67 33 or book online at www.innomedtraining.co.uk Innomed Training 265mm x 95mm half page

Cosmetic News October 2013

TO REGISTER WWW.SKINGEEKS.CO.UK/TRAINING OR CALL 01865 338046

DIRECTORY ABC Laser Contact: Guy Gouldsmit T: 08451 707 788 E: info@a-b-c-uk.com W: www.abclasers.co.uk

Aesthetic Source Contact: Sharon Morris T: 01234 313 130 E: sharon@aestheticsource.com Services: NeoStrata and Exuviance - Innovation in Aesthetics delivered to you.

Aesthetox Academy Contact: Lisa Tyrer Service: Training T: 0870 0801746 E: treatments@aesthetox.co.uk W: www.aesthetox.co.uk

Allergan Contact: Customer Service T: 0808 2381500 W: www.juvedermultra.co.uk

Hamilton Fraser Contact: Wai Chan T: 0845 3106 300 E: cosmetic@hamiltonfraser.co.uk W: hamiltonfraser.co.uk

Carlton Group Beauty & Spa (The) Contact: UK Sales Office T: 01903 761100 E: info@thecarltongroup.co.uk W: www.thecarltongroup.co.uk

Chromogenex Service: Laser System Manufacturer Contact: Lauren Roberts T: 01554 755444 E: lroberts@chromogenex.com W: www.chromogenex.com

Mesoestetic UK Contact: Adam Birtwistle T: 01746 718123 E: contact@mesoestetic.co.uk W: www.mesoestetic.co.uk Services: Cosmeceutical Skincare Treatment Solutions. Cosmelan.

Antiagaing, Depigmentation, Anti Acne, Dermamelan.

Healthxchange Pharmacy Contact: Steve Joyce T: +44 (0)1481 736837 F: +44 (0)1481 736677 E: SJ@healthxchange.com W: www.healthxchange.com W: www.obagi.uk.com

Highgate Private Hospital Contact: Lee Huggon T: 020 8341 4182 E: lee.huggon@highgatehospital.co.uk W: www.highgatehospital.co.uk

DermaLUX Services: Manufacturer of LED Phototherapy Systems Contact: Louise Taylor Tel: 0845 689 1789 Email: louise@dermaluxled.com Web: www.dermaluxled.com

Merz Aesthetics Contact: Merz Aesthetics Customer Services T: 0333 200 4140 E: info@merzaesthetics.co.uk

Polaris Lasers Contact: Neil Calder Medical T: 01234841536 Microdermabrasion E: njc@polaris-laser.com From W: www.polaris-laser.com MATTIOLI ENGINEERING As featured on

Eden Aesthetics Contact: Anna Perry T: 01245 227 752 E: info@edenaesthetics.com W: www.edenaesthetics.com

Laser Physics Contact: Customer Services T: 01829773155 E: info@laserphysics.co.uk W: www.laserphysics.co.uk

SkinBrands Contact: Tracey Beesley T: 0289 983 739 E: tracey@skinbrands.co.uk W: www.skinbrands.co.uk

AZTEC Services Contact: Anthony Zacharek Service: Exclusive UK distributor for Viora product range needle free Intense Pulse Light (I PL) & Laser Systems TECHNICAL SUPPORT Mesotherapy T: 07747 865600 Lawrence Grant delivering the promise for the delivery of active Pulse Light (I2PL) & Laser Beautylight Technical Services Ltd Ellipse-Intense Contact: Jane Myerson E: sales@aztecservices.uk.com Contact – Alan Rajah Skin Geeks Ltd Contact: Jane Myerson Contact: Ashaki Vidale substances.

SystemsT: 0208 741 1111 W: www.aztecservices.uk.com T: 0208 861 7575 T: 0208 741 1111 Contact: Customer Services T: 0208 741 1111 sales@ellipseipl.co.uk Myerson Contact:E:Jane E: lgmail@lawrencegrant.co.uk E: sales@ellipseipl.co.uk T: +44 (0)1865 338046 E: ashaki@ellipseipl.co.uk W: www.ellipseipl.co.uk T: 0208 741 1111 W: www.lawrencegrant.co.uk/specialistW: www.venusconceptuk.co.uk W: www.technicalsupport.ellipseipl.co.uk/ E: info@skingeeks.co.uk Services: UK distributor of IPL & Laser E: sales@ellipseipl.co.uk Services: UKservices/doctors.htm distributor of Venus Tel: 01234 841536 Services: Onsite service & repairs of W: www.skingeeks.co.uk systems, IPL & Laser training courses Freeze and Swan Radio Frequency (RF) www.polarismedicallasers.co.uk aesthetic systems. UK agent for EllipseW: www.ellipseipl.co.uk and technical support & Magnetic Pulse (MP) systems IPL & Venus Radio Frequency systems Services: UK distributor of IPL & Laser systems, IPL & Bioptica Laser Aesthetics Laser training courses and technical support Contact: Mike Regan T: +44 (0)7917 573466 Lifestyle Aesthetics E: mike.regan@bla-online.co.uk Contact: Sue Wales W: www.bla-online.co.uk T: 0845 0701 782 Sound Surgical (UK) LTD Services: Core of Knowledge Training and Laser E: info@lifestyleaestheics.com Contact: Raj Jain Protection Adviser (LPA) Services.

Intense Pulse Light (I2PL) & Laser Systems TECHNICAL SUPPORT delivering the T: promise W: www.lifestyleaesthetics.com +44 7971 686114 Beautylight Technical Services Ltd Contact: Jane Myerson Ellipse Technical Support E: rjain@soundsurgical.com Contact: Jane Myerson Contact: Ashaki Vidale T: 0208 741 1111 Beautylight Technical Services Ltd T: 0208 741 1111 Web: www.SoundSurgical.co.uk T: 0208 741 1111 E: sales@ellipseipl.co.uk Contact: Ashaki Vidale E: sales@ellipseipl.co.uk E: ashaki@ellipseipl.co.uk W: www.ellipseipl.co.uk T: 0208W: 741 1111 W: www.venusconceptuk.co.uk www.technicalsupport.ellipseipl.co.uk/ Services: UK distributor of IPL & Laser Services: UK distributor of Venus E: ashaki@ellipseipl.co.uk Boston Medical Group LTD Services: Onsite service & repairs of systems, IPL & Laser training courses Freeze and Swan Radio Frequency (RF) aesthetic systems. UK agent for Ellipse W: www.technicalsupport.ellipseipl.co.uk/ Contact: Iveta Vinklerova and technical support & Magnetic Pulse (MP) systems IPL & Venus Radio Frequency systems Services: Onsite service & repairs of aesthetic systems.

T: 0207 727 1110 Lynton UK agent for Ellipse IPL & Venus Radio Frequency systems E: info@boston-medical-group.co.uk Contact: Customer Services Intense Pulse Light (I PL) & Laser Systems TECHNICAL SUPPORT delivering the promise W: www.boston-medical-group.co.uk T:Technical 0845 6121545 Beautylight Services Ltd Contact: Jane Myerson Contact: Jane Myerson Contact: Ashaki Vidale E: info@lynton.co.uk T: 0208 741 1111 Venus Freeze T: 0208 741 1111 T: 0208 741 1111 E: sales@ellipseipl.co.uk W: www.lynton.co.uk Contact:E:Jane Myerson sales@ellipseipl.co.uk E: ashaki@ellipseipl.co.uk W: www.ellipseipl.co.uk T: 0208 741 1111 W: www.venusconceptuk.co.uk W: www.technicalsupport.ellipseipl.co.uk/ Services: UK distributor of IPL & Laser Services: UK distributor of Venus E: sales@ellipseipl.co.uk Services: Onsite service & repairs of systems, IPL & Laser training courses Freeze and Swan Radio Frequency (RF) aesthetic systems. UK agent for Ellipse W: www.venusconceptuk.co.uk and technical support & Magnetic Pulse (MP) systems Energist Medical Group IPL & Venus Radio Frequency systems Candela UK Ltd Med-fx Services: UK distributor of Venus Freeze and Swan Contact: Eddie Campbell-Adams Contact: Michaela Barker Contact: Faye Price Radio Frequency (RF) & Magnetic Pulse (MP)2 systems T: 01792 798 768 T: 0845 521 0698 T: 01376 532800 E: info@energistgroup.com E: MichaelaB@syneron-candela.co.uk E: sales@medfx.co.uk W: www.energistgroup.com W: www.syneron-candela.co.uk W: www.medfx.co.uk 2

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Carleton Medical Ltd Contact: Nick Fitrzyk T: 01633 838 081 E: nf@carletonmedical.co.uk W: www.carletonmedical.co.uk Services: UK distributor of Asclepion Lasers

Galderma Aesthetic & Corrective Division Contact: Customer Services T: 01923 808950 E: info.uk@galderma.com W: www.galderma-alliance.co.uk

58 www.cosmeticnewsuk.com

Medical Aesthetic Group Contact: David Gower T: 02380 676733 E: info@magroup.co.uk W: www.magroup.co.uk

Zanco Models Contacts: Mr Ricky Zanco T: 08453076191 E: info@zancomodels.co.uk W: www.zancomodels.co.uk

For less than £25 per month, you can list your company details here.

For more information contact Cosmetic News • 01268 754897 support@cosmeticnewsuk.com

F or m e d i u m to d e e p d e pr e s s i o n s i n clu d i n g na so - l ab ial F o lds . 1

WITH LIDOCAINE

A highly versatile, injectable gel using VYCROSS™ technology.1

reference: 1. Juvéderm VOLIFT with Lidocaine DFU, 2013.

Allergan, Marlow International, 1st Floor, The Parkway Marlow, Buckinghamshire SL7 1YL, UK | May 2013 UK/0658/2013